Individual provider Active NPI

Edward Brooks Weller, MD

  • Orthopaedic Surgery Physician
  • High Point, NC
National Provider Identifier
1477552115
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
28375 Issued in NC
Practice address
611 N Lindsay St
Suite 200
High Point, NC 27262-4300
Phone
(336) 802-2250
Fax
(336) 802-2251
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 28375 NC Primary

Addresses

Primary practice location

611 N Lindsay St
Suite 200
High Point, NC 27262-4300

Mailing address

1701 Westchester Drive
Suite 850
High Point, NC 27262-7254
Phone (336) 802-2400

Other identifiers 2

IdentifierTypeStateIssuer
8986454MedicaidNC
P00327492OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20060718000326 NC Practitioner - Orthopedic Surgery 4486667367

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care PA Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1477552115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N LINDSAY ST",
            "address_2": "SUITE 200",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624300",
            "telephone_number": "336-802-2250",
            "fax_number": "336-802-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "EDWARD",
        "middle_name": "BROOKS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "28375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8986454",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00327492",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.