Individual provider Active NPI

Donald C Weldon

  • Internal Medicine Physician
  • Beatrice, NE
National Provider Identifier
1285639658
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16679 Issued in NE
Practice address
1201 N 10TH St
Beatrice, NE 68310-2003
Phone
(402) 228-3545
Fax
(402) 228-3826
NPI assigned
Jun 14, 2005
Reactivated
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16679 NE Primary
Rural Health Clinic/Center 261QR1300X 16679 NE

Addresses

Primary practice location

1201 N 10TH St
Beatrice, NE 68310-2003

Mailing address

1201 N 10TH St
Beatrice, NE 68310-2003
Phone (402) 228-3545

Other identifiers 2

IdentifierTypeStateIssuer
00733OtherNEBLUE CROSS BLUE SHIELD
47071415401MedicaidNE

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

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1285639658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N 10TH ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683102003",
            "telephone_number": "402-228-3545",
            "fax_number": "402-228-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N 10TH ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683102003",
            "telephone_number": "402-228-3545",
            "fax_number": "402-228-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDON",
        "first_name": "DONALD",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2010-02-25",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "16679",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NE",
            "license": "16679",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00733",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47071415401",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beatrice, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.