Individual provider Active NPI

Alan William Weymouth, D.C.

  • Chiropractor
  • Ellsworth, ME
National Provider Identifier
1295725695
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR562 Issued in ME
Practice address
194 Beechland Rd
Ellsworth, ME 04605-2536
Phone
(207) 667-3001
Fax
(207) 667-4501
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR562 ME Primary

Addresses

Primary practice location

194 Beechland Rd
Ellsworth, ME 04605-2536

Mailing address

194 Beechland Rd
Ellsworth, ME 04605-2536
Phone (207) 667-3001

Other identifiers 3

IdentifierTypeStateIssuer
005795OtherMEANTHEM BC/BS
111700000MedicaidME
10904039OtherMECAQH

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

State licenses

LicenseStateTypeSpecialty
CR562MEMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1295725695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 BEECHLAND RD",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052536",
            "telephone_number": "207-667-3001",
            "fax_number": "207-667-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 BEECHLAND RD",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052536",
            "telephone_number": "207-667-3001",
            "fax_number": "207-667-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYMOUTH",
        "first_name": "ALAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "005795",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111700000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10904039",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.