Individual provider Active NPI

Michael G Weston

  • Driver
  • Jackson, MS
National Provider Identifier
1336604453
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
802422810 Issued in MS
Practice address
1944 Linda LN
Jackson, MS 39213-4447
Phone
(601) 383-7087
Fax
(601) 366-3090
NPI assigned
Feb 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 802422810 MS Primary

Addresses

Primary practice location

1944 Linda LN
Jackson, MS 39213-4447

Mailing address

1944 Linda LN
Jackson, MS 39213-4447
Phone (601) 383-7087

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
802422810MSMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1549065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1336604453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 LINDA LN",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134447",
            "telephone_number": "601-383-7087",
            "fax_number": "601-366-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 LINDA LN",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134447",
            "telephone_number": "601-383-7087",
            "fax_number": "601-366-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-02",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MS",
            "license": "802422810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; 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.