Lee Weathers, MS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101

Phone

(916) 226-2800

Fax

(916) 226-2804

NPI assigned

May 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lee Weathers-Miguel Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1619613981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9747 DENALI CIR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957576259",
            "telephone_number": "916-980-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9412 BIG HORN BLVD STE 6",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581101",
            "telephone_number": "916-226-2800",
            "fax_number": "916-226-2804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5445 Laurel Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958413105",
            "country_code": "US",
            "telephone_number": "916-609-5100",
            "fax_number": "916-609-5160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "LEE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "WEATHERS-MIGUEL",
            "credential": "MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Student in an Organized Health Care Education/Training Program in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.