Individual provider Active NPI

Sean Mathew Weiser, LMT

  • Specialist
  • Pensacola, FL
National Provider Identifier
1336384783
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA-32816 Issued in FL
Practice address
744 E Burgess Rd
Suite A105
Pensacola, FL 32504-6227
Phone
(850) 384-1023
NPI assigned
Dec 12, 2008
Last updated
Dec 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA-32816 FL Primary

Addresses

Primary practice location

744 E Burgess Rd
Suite A105
Pensacola, FL 32504-6227

Mailing address

1153 Willowood Cir
Gulf Breeze, FL 32563-5432
Phone (850) 384-1023

Other identifiers 1

IdentifierTypeStateIssuer
C1521OtherFLBCBS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA-32816FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1336384783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 WILLOWOOD CIR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325635432",
            "telephone_number": "850-384-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 E BURGESS RD",
            "address_2": "SUITE A105",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046227",
            "telephone_number": "850-384-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISER",
        "first_name": "SEAN",
        "middle_name": "MATHEW",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA-32816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "C1521",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.