Progressive Medicine of Ithaca, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

224502 Issued in NY

Legal business name

PROGRESSIVE MEDICINE OF ITHACA, PC

Practice address

402 3Rd Street
Suite 2
Ithaca, NY 14850

Phone

(607) 272-9938

Fax

(607) 272-9996

NPI assigned

Feb 20, 2008

Last updated

May 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John W Weston, DO

Title

Owner

Phone

(607) 272-9938

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1467621797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 3RD STREET",
            "address_2": "SUITE 2",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-272-9938",
            "fax_number": "607-272-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 3RD STREET",
            "address_2": "SUITE 2",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-272-9938",
            "fax_number": "607-272-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE MEDICINE OF ITHACA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "WESTON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-272-9938",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "224502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02383448",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.