Individual provider Active NPI

Nicole Weydert

  • Massage Therapist
  • Naperville, IL
National Provider Identifier
1548611130
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227013408 Issued in IL
Practice address
1250 S Naper Blvd
Naperville, IL 60540-8312
Phone
(630) 527-9100
NPI assigned
Jun 25, 2016
Last updated
Jun 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227013408 IL Primary

Addresses

Primary practice location

1250 S Naper Blvd
Naperville, IL 60540-8312

Mailing address

2096 Sand Hill CT
Montgomery, IL 60538-6000
Phone (630) 527-9100

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
227013408ILMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pins Family Chiropractic Past Accepting new patients
Frank Bendiks, DC, PC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1548611130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2096 SAND HILL CT",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605386000",
            "telephone_number": "630-527-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S NAPER BLVD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408312",
            "telephone_number": "630-527-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYDERT",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-25",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227013408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.