Active NPI
Kenneth G Weston, M.D.
- Family Medicine Physician
- Columbia, MO
National Provider Identifier
1295809275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MDR4C65
- Practice address
- 303 N Keene St
Suite 301
Columbia, MO 65201-7193 - Phone
- (573) 449-0808
- Fax
- (573) 442-1331
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MDR4C65 | MO | Primary |
Addresses
Primary practice location
303 N Keene St
Suite 301
Columbia, MO 65201-7193
Mailing address
303 N Keene St
Suite 301
Columbia, MO 65201-7193
Phone (573) 449-0808
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-9492 | Other | UNITED HEALTH CARE | |
| 201483914 | Medicaid | MO | |
| 4369507 | Other | AETNA | |
| 25787 | Other | MO | BLUE CROSS BLUE SHIELD |
| 102652 | Other | HEALTHLINK | |
| 54599 | Other | GROUP HEALTH PLANS |
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 |
|---|---|---|---|
| MDR4C65 | MO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244160000000",
"number": "1295809275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N KEENE ST",
"address_2": "SUITE 301",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652017193",
"telephone_number": "573-449-0808",
"fax_number": "573-442-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N KEENE ST",
"address_2": "SUITE 301",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652017193",
"telephone_number": "573-449-0808",
"fax_number": "573-442-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTON",
"first_name": "KENNETH",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2009-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "MDR4C65",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "01-9492",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201483914",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4369507",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "25787",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "102652",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLANS",
"identifier": "54599",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.