Organization Active NPI

JM Weida MD CJ Sondgerath MD

  • Family Medicine Physician
  • Lafayette, IN
National Provider Identifier
1629275243
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JM WEIDA MD CJ SONDGERATH MD
Practice address
3005 Greenbush St
Lafayette, IN 47904-2435
Phone
(765) 447-3103
Fax
(765) 449-4782
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Mrs. Laura Jane Odle
Title
Insurance Specialist
Phone
(765) 447-3103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IN Primary

Addresses

Primary practice location

3005 Greenbush St
Lafayette, IN 47904-2435

Mailing address

3005 Greenbush St
Lafayette, IN 47904-2435
Phone (765) 447-3103

Other identifiers 2

IdentifierTypeStateIssuer
000000375905OtherINGROUP ANTHEM NUMBER
200325640AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1629275243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042435",
            "telephone_number": "765-447-3103",
            "fax_number": "765-449-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042435",
            "telephone_number": "765-447-3103",
            "fax_number": "765-449-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JM WEIDA MD CJ SONDGERATH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "ODLE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "765-447-3103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ANTHEM NUMBER",
            "identifier": "000000375905",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200325640A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.