Individual provider Active NPI

Joseph Lorenzo Weidman II, M.D.

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1679739858
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2016-01176 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 749-5800
Fax
(704) 626-3237
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 51885 SC
Anesthesiology Physician 207L00000X 2016-01176 NC Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

3735 Glenlake Dr Ste 250
Charlotte, NC 28208-6866
Phone (704) 749-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161208001962 NC Practitioner - Anesthesiology 4082872585 Reassigns benefits to 1 organization
I20180420001725 SC Practitioner - Anesthesiology 4082872585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Baylor College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4000

1800 E 4TH St
Charlotte, NC 28204-3210
Phone (704) 384-1300

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-01176NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Oct 24, 2016 Accepting new patients
Ambulatory Anesthesia of Pinehurst, PA Anesthesiology Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

200 Providence Rd
Ste 101
Charlotte, NC 28207

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1679739858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 GLENLAKE DR STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282086866",
            "telephone_number": "704-749-5800",
            "fax_number": "704-626-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-749-5800",
            "fax_number": "704-626-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDMAN",
        "first_name": "JOSEPH",
        "middle_name": "LORENZO",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "51885",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2016-01176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.