Brooke Malanga Weissman, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11849 Issued in NC

Practice address

4503 Main St
Shallotte, NC 28470-4447

Phone

(910) 721-3157

Fax

(910) 754-5577

NPI assigned

Jan 19, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1639316219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704447",
            "telephone_number": "910-721-3157",
            "fax_number": "910-754-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "BROOKE",
        "middle_name": "MALANGA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Diane Warren, MSW, LCSW
• Waterside Healthcare Inc. (Shallotte Assisted Living)
• Melissa Buckner Wayne, NP-C
• Debra C Webb, OD
• Monique Weddle, D.C.
• Gwen Weller, FNP-C
• Taylo Arlyn Weschler, COTA/L
• Sameria Danielle Wesley, MSW LCSWA
• David Chadwick Weston, M.D.
• Marie McMillan Wheatley, FNP-C

• Physical Therapist in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.