Individual provider Active NPI

Marc Weatherford, LPN

  • Licensed Practical Nurse
  • Cleveland Heights, OH
National Provider Identifier
1467762138
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN117641 Issued in OH
Practice address
1823 Lee Rd Apt 101
Cleveland Heights, OH 44118-2152
Phone
(216) 371-9330
NPI assigned
Oct 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN117641 OH Primary

Addresses

Primary practice location

1823 Lee Rd Apt 101
Cleveland Heights, OH 44118-2152

Mailing address

1823 Lee Rd Apt 101
Cleveland Heights, OH 44118-2152
Phone (216) 371-9330

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
PN117641OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1467762138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 LEE RD APT 101",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441182152",
            "telephone_number": "216-371-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 LEE RD APT 101",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441182152",
            "telephone_number": "216-371-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERFORD",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN117641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.