Micah James Weller, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95005719 Issued in CA

Practice address

1880 N Orange Grove Ave
Pomona, CA 91767-3006

Phone

(909) 620-7200

NPI assigned

Jan 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1639314255
  Medicare reassignment NPD
• Hospitalist Corporation of Inland Empire

  • Hospitalist Physician
  • Pomona, CA
  • NPI 1124317615
  Medicare reassignment
• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1063191575
  NPD

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

{
    "created_epoch": "1483833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1629514153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 N ORANGE GROVE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673006",
            "telephone_number": "909-620-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5549 Van Buren Blvd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925032068",
            "country_code": "US",
            "telephone_number": "951-324-5901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLER",
        "first_name": "MICAH",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-08",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyama Clarissa Welch
• Well and Fit Adult Day Health Care, Inc
• Cole Thomas Welle
• Jesse Bryan Weller, PSY.D.
• Marc L. Weller, M.D.
• Wellness Detox la LLC
• Wellnest Medical Clinic Corp
• Wells Pharmacy, Inc
• Hannah Wells
• Patricia Wells

• Family Nurse Practitioner in Pomona, CA
• Providers in Pomona, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.