J Weber Medical Group PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

J WEBER MEDICAL GROUP PLLC

Practice address

620 Woodmere Ave Ste C
Traverse City, MI 49686-3397

Phone

(800) 639-0414

Fax

(231) 947-0977

NPI assigned

Apr 15, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey Scott Weber, DPMNPI 1043655822

Title

Owner

Phone

(231) 946-8822

Specialties & licenses 1

Addresses

Other names 1

• Birch Tree Foot and Ankle Specialists Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.weber@bp.eclinicaldirectplus.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Scott Weber, D.P.M.

  • Podiatrist
  • Traverse City, MI
  • NPI 1043655822
  Medicare reassignment NPD Authorized official
• Daniel T Lathrop, DPM

  • Podiatrist
  • Traverse City, MI
  • NPI 1710925706
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1285297481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WOODMERE AVE STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863397",
            "telephone_number": "800-639-0414",
            "fax_number": "231-947-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WOODMERE AVE STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863397",
            "telephone_number": "800-639-0414",
            "fax_number": "231-947-0977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "294 River St",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496601475",
            "country_code": "US",
            "telephone_number": "231-723-4500",
            "fax_number": "231-947-0977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "J WEBER MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-946-8822",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.weber@bp.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "620 Woodmere Ave Ste C",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496863397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Birch Tree Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Birch Tree Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaemi D Irelan-Dunn
• Victoria Isac-Huggins, PA
• Jessica Renee Isit
• Dianna J Ives, PT
• J B Zoutendam DDS PC
• J. Donberg, LLC
• J. Eric Zimmerman, M.D., P.C.
• Jordan Jabara, MD
• Mark A Jackson, MD
• Matthew R Jackson, D.O.

• Foot & Ankle Surgery Podiatrist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.