Active NPI
William Michael Weiss I, RN
- Registered Nurse
- Maryville, IL
National Provider Identifier
1649726340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041.296738
- Practice address
- 2148 Vadalabene Dr
Maryville, IL 62062-5632 - Phone
- (618) 288-3100
- NPI assigned
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.296738 | IL | Primary |
Addresses
Primary practice location
2148 Vadalabene Dr
Maryville, IL 62062-5632
Mailing address
2148 Vadalabene Dr
Maryville, IL 62062-0001
Phone (618) 288-3100
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.296738 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1649726340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2148 VADALABENE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620620001",
"telephone_number": "618-288-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2148 VADALABENE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625632",
"telephone_number": "618-288-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "WILLIAM",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"name_suffix": "I",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.296738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.