Individual provider Active NPI

Ronald D Weddle, M.D.

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1326049552
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17429 Issued in KY
Practice address
7926 Preston Hwy
Ste. 106
Louisville, KY 40219-3848
Phone
(502) 964-4357
Fax
(502) 966-5948
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17429 KY Primary

Addresses

Primary practice location

7926 Preston Hwy
Ste. 106
Louisville, KY 40219-3848

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 3

IdentifierTypeStateIssuer
133731OtherKYSIHO- NCMA
K037340OtherKYMEDICARE- NORTON MEDICAL ASSOCIATES
64174295MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060126000503 KY Practitioner - Family Practice 6103830385 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17429KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Fast Pace Kentucky PLLC Family Medicine CurrentSince Apr 1, 2018 Accepting new patients
Community Medical Associates, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

796 W Broadway St
Campbellsville, KY 42718
Phone (270) 572-4933

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

7926 Preston Hwy
Louisville, KY 40219
Phone (502) 964-4357

7926 Preston Hwy
Ste 106
Louisville, KY 40219
Phone (502) 964-4357

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

1023 W Main St
Princeton, KY 42445
Phone (270) 254-5840

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1326049552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 PRESTON HWY",
            "address_2": "STE. 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193848",
            "telephone_number": "502-964-4357",
            "fax_number": "502-966-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDLE",
        "first_name": "RONALD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "17429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO- NCMA",
            "identifier": "133731",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- NORTON MEDICAL ASSOCIATES",
            "identifier": "K037340",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64174295",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.