Vickie K Weathers, CNS

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

0388003-02 Issued in ND

Practice address

307 5TH Ave SE
Suite 502
Minot, ND 58701-4784

Phone

(701) 857-2199

Fax

(701) 857-2199

NPI assigned

Jun 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Nurse Specialist

State licenses

Practice roles

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.

• North Central Behavioral Health Clinic

  • Clinic/Center
  • Minot, ND
  • NPI 1477592533
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1649215070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 4TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032912",
            "telephone_number": "701-839-0474",
            "fax_number": "701-839-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 5TH AVE SE",
            "address_2": "SUITE 502",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014784",
            "telephone_number": "701-857-2199",
            "fax_number": "701-857-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "VICKIE",
        "middle_name": "K",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R28599",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "ND",
            "license": "L9274",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "ND",
            "license": "0388003-02",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ND PIN",
            "identifier": "025500",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70009",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00160106",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00659747",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patanit Watanaboonyakhet, MD
• Gwendolyn Waters, CNA
• Mercedes Watkins
• Lorea Jean Watson, LPCC
• Derek Wax
• Elizabeth Marie Webb, DSP
• Alyssa Weber, PSYD
• Jonathan Ray Webster
• Lynwood N Wedar, P.T.
• Shanda A Weiand

• Clinical Nurse Specialist in Minot, ND
• Providers in Minot, ND by specialty
• Clinical Nurse Specialist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.