Shaun Weissman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT297021 Issued in CA

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 423-7899

NPI assigned

Dec 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1336788249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "SHAUN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-26",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT297021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "270 International Cir",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951191130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa D. Webster, RD
• Justin Wei, MD
• Amanda Marie Weindl, DO
• Carolyn K. Weiss, RPH
• Laura Weiss
• David Welch
• Patricia K. Welch
• Maria Camacho West, PT
• Marquise Westbrook, MD
• Suk Charles Whang, M.D.

• Physical Therapist in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.