Individual provider Active NPI

Donald Gregory Weathers, M.D.

  • Adult Medicine Physician
  • Toledo, OH
National Provider Identifier
1407832918
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
35044035 Issued in OH
Practice address
3949 Sunforest CT
Suite 202
Toledo, OH 43623-4473
Phone
(419) 474-1111
Fax
(419) 474-1255
NPI assigned
Dec 16, 2005
Last updated
Sep 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 35044035 OH Primary

Addresses

Primary practice location

3949 Sunforest CT
Suite 202
Toledo, OH 43623-4473

Mailing address

2200 Jefferson Ave
4TH Floor - Attn: Judy Kornmeier
Toledo, OH 43604-7101
Phone (419) 251-1963

Other identifiers 1

IdentifierTypeStateIssuer
0400702MedicaidOH

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35044035OHMDAdult Medicine Physician

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1407832918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "4TH FLOOR - ATTN: JUDY KORNMEIER",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101",
            "telephone_number": "419-251-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 SUNFOREST CT",
            "address_2": "SUITE 202",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234473",
            "telephone_number": "419-474-1111",
            "fax_number": "419-474-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "DONALD",
        "middle_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "35044035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0400702",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.