Charlotte Esther Weeda, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M-15362 Issued in ID

Practice address

700 W. Ironwood Drive
Suite 155
Coeur D'Alene, ID 83814-4462

Phone

(208) 667-0585

Fax

(208) 625-2075

NPI assigned

May 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Charlotte Esther Stiles Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: charlotte.weeda@cdapeds.directbygreenway.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dirne Health Centers, Inc.

  dba Heritage Health Main

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1285686477
  Medicare reassignment
• Coeur D'Alene Pediatrics PA

  • Pediatrics Physician
  • Coeur d'Alene, ID
  • NPI 1255496980
  NPD (past)

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1659582872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-928-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W. IRONWOOD DRIVE",
            "address_2": "SUITE 155",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "838144462",
            "telephone_number": "208-667-0585",
            "fax_number": "208-625-2075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 N Vercler Rd",
            "address_2": "Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992161092",
            "country_code": "US",
            "telephone_number": "509-928-6383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEEDA",
        "first_name": "CHARLOTTE",
        "middle_name": "ESTHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD150157",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60614530",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M15362",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M-15362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOTTE",
            "last_name": "STILES",
            "middle_name": "ESTHER",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin Robert Webb, M.D.
• Megan Elizabeth Webb, PT, DPT
• Friedrich J. Weber Jr., PT
• Jodi Weber, LMSW
• Melinda Renee Weber, PT
• Katherine Joanne Cuccia Weeks, SLP-CCC
• Megan Ann Weeks, ARNP
• Jennifer Lyn Wegler, PA
• Timothy Clark Weill, MD
• Courtney K. Weimer

• Pediatrics Physician in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Pediatrics Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.