Individual provider Active NPI

James D Weber, D.D.S.

  • Dentist
  • Michigan City, IN
National Provider Identifier
1578975223
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011944A Issued in IN
Practice address
1213 E Coolspring Ave
Michigan City, IN 46360-6319
Phone
(219) 872-9151
NPI assigned
May 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011944A IN Primary

Addresses

Primary practice location

1213 E Coolspring Ave
Michigan City, IN 46360-6319

Mailing address

1213 E Coolspring Ave
#205
Michigan City, IN 46360-6319
Phone (317) 726-6055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322000982 IN Order and Referring Only - DentistPractitioner - Dentist 5395042170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011944AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1578975223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 E COOLSPRING AVE",
            "address_2": "#205",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606319",
            "telephone_number": "317-726-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606319",
            "telephone_number": "219-872-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "JAMES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011944A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.