Active NPI
James Edward Weiss, M.D.
- Dermatology Physician
- Salt Lake City, UT
National Provider Identifier
1275745838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD08770
- Practice address
- 4021 S 700 E
Suite 300
Salt Lake City, UT 84107-2192 - Phone
- (888) 474-3786
- Fax
- (866) 588-1022
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD08770 | OR | Primary |
Addresses
Primary practice location
4021 S 700 E
Suite 300
Salt Lake City, UT 84107-2192
Mailing address
1520 SW Clifton St
Portland, OR 97201-3138
Phone (503) 243-3852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD08770 | OR | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275745838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 SW CLIFTON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972013138",
"telephone_number": "503-243-3852",
"fax_number": "503-243-6149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4021 S 700 E",
"address_2": "SUITE 300",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841072192",
"telephone_number": "888-474-3786",
"fax_number": "866-588-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "JAMES",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OR",
"license": "MD08770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.