Willis Fred Weeden Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

131238 Issued in NY

Practice address

5005 State Route 64
Canandaigua, NY 14424-9358

Phone

(585) 229-2595

NPI assigned

Mar 24, 2011

Last updated

Mar 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1538468947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 STATE ROUTE 64",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144249358",
            "telephone_number": "585-229-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 STATE ROUTE 64",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144249358",
            "telephone_number": "585-229-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEDEN",
        "first_name": "WILLIS",
        "middle_name": "FRED",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "131238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice May Weaver, PTA
• Beth Mattoon Webster
• Cassandra Webster
• Hannah Elise Weeden, LMSW
• Robert F Weeden, D.O.
• Wegmans Food Markets, Inc. (Wegmans Pharmacy #011)
• Justin M Weis, M.D.
• Erika M Weise, FNP-C
• Reece Andre Weitzel, M.A.
• Jaman P Welch, PH.D.

• Internal Medicine Physician in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.