Individual provider Active NPI

Kristopher Ross Weemes, D.O.

  • Obstetrics & Gynecology Physician
  • Fort Payne, AL
National Provider Identifier
1679860258
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101019307 Issued in MI
Practice address
550 Medical Center Dr SW
Fort Payne, AL 35968-3418
Phone
(256) 845-8885
Fax
(256) 845-9546
NPI assigned
Jul 5, 2011
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101019307 MI Primary

Addresses

Primary practice location

550 Medical Center Dr SW
Fort Payne, AL 35968-3418

Mailing address

550 Medical Center Dr SW
Fort Payne, AL 35968-3418
Phone (256) 845-8885

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190321001965 AL Practitioner - Obstetrics/Gynecology 5193033181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Isbell Medical Group PCGroup PAC ID 0446247902, 3 clinicians
Dekalb Specialty CareGroup PAC ID 5991244378, 20 clinicians

Practice addresses (Care Compare)

550 Medical Ctr Dr SW
Fort Payne, AL 35968-3418
Phone (256) 845-8885

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019307MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Isbell Medical Group, P.C. Obstetrics & Gynecology CurrentSince Jan 28, 2019 Accepting new patients
Fort Payne Hospital Corporation Past Accepting new patients
HH Health System - Dekalb, LLC Past Accepting new patients

Locations

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

550 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-6293

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1679860258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683418",
            "telephone_number": "256-845-8885",
            "fax_number": "256-845-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683418",
            "telephone_number": "256-845-8885",
            "fax_number": "256-845-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEMES",
        "first_name": "KRISTOPHER",
        "middle_name": "ROSS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101019307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.