Active NPI
Sandra L Weidner, M.D.
- Pediatrics Physician
- Wyomissing, PA
National Provider Identifier
1629074943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD041246E
- Practice address
- 2240 Ridgewood Rd
Ste 100
Wyomissing, PA 19610-1167 - Phone
- (610) 376-8691
- Fax
- (610) 376-8745
- NPI assigned
- Jun 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD041246E | PA | Primary |
Addresses
Primary practice location
2240 Ridgewood Rd
Ste 100
Wyomissing, PA 19610-1167
Mailing address
2240 Ridgewood Rd
Ste 100
Wyomissing, PA 19610-1167
Phone (610) 376-8691
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06036 | Other | PA | EPSDT |
| 1123140 | Medicaid | PA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD041246E | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Childrens Clininic of Wyomissing | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Wyomissing, PA
- NPI 1356341770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1629074943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2240 RIDGEWOOD RD",
"address_2": "STE 100",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196101167",
"telephone_number": "610-376-8691",
"fax_number": "610-376-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 RIDGEWOOD RD",
"address_2": "STE 100",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196101167",
"telephone_number": "610-376-8691",
"fax_number": "610-376-8745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIDNER",
"first_name": "SANDRA",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD041246E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EPSDT",
"identifier": "06036",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1123140",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyomissing, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.