Individual provider Active NPI

Kathy Jane Weishaar, MD

  • Internal Medicine Physician
  • Frederick, MD
National Provider Identifier
1629031828
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0062975 Issued in MD
Practice address
400 W 7TH St
Frederick, MD 21701-4506
Phone
(240) 566-4722
Fax
(240) 566-4755
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0062975 MD Primary

Addresses

Primary practice location

400 W 7TH St
Frederick, MD 21701-4506

Mailing address

2781 Crystal Woods Dr
Finksburg, MD 21048-3000
Phone (410) 259-0679

Other identifiers 1

IdentifierTypeStateIssuer
407945100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050427001142 MD Practitioner - HospitalistPractitioner - Internal Medicine 5395784532 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062975MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Green Spring Internal Medicine, LLC Internal Medicine PastSince Jul 1, 2006 Accepting new patients

Locations

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

400 W 7th St
#H
Frederick, MD 21701
Phone (240) 566-3300

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGJBAA

Organizations & group practices 3

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1629031828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 CRYSTAL WOODS DR",
            "city": "FINKSBURG",
            "state": "MD",
            "postal_code": "210483000",
            "telephone_number": "410-259-0679",
            "fax_number": "240-566-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-4722",
            "fax_number": "240-566-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISHAAR",
        "first_name": "KATHY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0062975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407945100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.