Organization Active NPI

Deborah L Weidinger LMLP, PA

  • Psychologist
  • Leavenworth, KS
National Provider Identifier
1659640209
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
825 Issued in KS
Legal business name
DEBORAH L WEIDINGER LMLP, PA
Practice address
1301 S Broadway St
Leavenworth, KS 66048-3119
Phone
(913) 651-4123
NPI assigned
Dec 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Authorized official

Name
Dr. Deborah L Weidinger, LPNPI 1043381478
Title
Psychologist
Phone
(913) 651-4123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 825 KS Primary

Addresses

Primary practice location

1301 S Broadway St
Leavenworth, KS 66048-3119

Mailing address

1301 S Broadway St
Leavenworth, KS 66048-3119
Phone (913) 651-4123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200812000722 KS Part B Supplier - Clinic/Group Practice 0446677231 Receives reassigned benefits from 1 practitioner
Practice locations: Leavenworth, KS

National Provider Directory

National Provider Directory

Locations

512 S 5th St
Leavenworth, KS 66048
Phone (913) 651-4123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1659640209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S BROADWAY ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660483119",
            "telephone_number": "913-651-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S BROADWAY ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660483119",
            "telephone_number": "913-651-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH L WEIDINGER LMLP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "WEIDINGER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "913-651-4123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "KS",
            "license": "825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.