Active NPI
Nicholas Weslow
- Physician Assistant
- Charleston, SC
National Provider Identifier
1649034257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11425
- Practice address
- 215 Promenade Vista St Apt 1117
Charleston, SC 29412-5107 - Phone
- (414) 998-3793
- NPI assigned
- Feb 13, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11425 | AZ | Primary |
Addresses
Primary practice location
215 Promenade Vista St Apt 1117
Charleston, SC 29412-5107
Mailing address
7695 E Pasaro Dr
Scottsdale, AZ 85266-2776
Phone (414) 998-3793
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1649034257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7695 E PASARO DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852662776",
"telephone_number": "414-998-3793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 PROMENADE VISTA ST APT 1117",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294125107",
"telephone_number": "414-998-3793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESLOW",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-13",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "11425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.