Individual provider Active NPI

Christopher Weirtz, D.O

  • Pediatrics Physician
  • Appleton, WI
National Provider Identifier
1447630595
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
22558 Issued in WI
Practice address
2701 E Enterprise Ave
Appleton, WI 54913-7729
Phone
(920) 954-2551
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X DOS-1777 HI
Pediatrics Physician 208000000X 22558 WI Primary

Addresses

Primary practice location

2701 E Enterprise Ave
Appleton, WI 54913-7729

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 954-2551

Other practice location 1

1 Jarrett White Rd
Tripler Army Medical Center
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-6345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220809001989 WI Practitioner - Pediatric Medicine 3375925225 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22558WIMDPediatrics Physician
DOS-1777HIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jul 1, 2022 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

2701 E Enterprise Ave
Appleton, WI 54913
Phone (920) 954-2551

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

640 Deerwood Ave
Neenah, WI 54956
Phone (920) 727-8622

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: cweirtz324619@direct.thedacare.org

Organizations & group practices 2

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1447630595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-954-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 E ENTERPRISE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137729",
            "telephone_number": "920-954-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_2": "Tripler Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-6345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIRTZ",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "DOS-1777",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "22558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.