Theodore Joseph Weber, M.DIV., PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY6429 Issued in FL

Practice address

348 Chelsea Place Ave
Ormond Beach, FL 32174-0683

Phone

(386) 795-7673

Fax

(386) 677-2107

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1316975691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 CHELSEA PLACE AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321740683",
            "telephone_number": "386-795-7673",
            "fax_number": "386-677-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 CHELSEA PLACE AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321740683",
            "telephone_number": "386-795-7673",
            "fax_number": "386-677-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "THEODORE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.DIV., PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6429",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Allan Walsh, DC
• Huijian James Wang, MD
• Daniel A Warner, MD
• Bryon Lee Washington, DC
• We Care Home Care Companion Services, Inc.
• Heidi Weece
• Rachael Mary Weightman, PTA
• Pamela Weiker, A.R.N.P.
• Alexis Marie Weir, SRNA, BSN, RN
• Robin Lynch Weiss, M.S.

• Psychologist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.