Active NPI
Joy A Weydert, M.D.
- Pediatrics Physician
- Kansas City, KS
National Provider Identifier
1689623183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 04-34064
- Practice address
- 3901 Rainbow Blvd
Mail Stop 4004
Kansas City, KS 66103-2937 - Phone
- (913) 588-6364
- Fax
- (913) 588-6338
- NPI assigned
- May 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2002029455 | MO | |
| Pediatrics Physician | 208000000X | 04-34064 | KS | Primary |
Addresses
Primary practice location
3901 Rainbow Blvd
Mail Stop 4004
Kansas City, KS 66103-2937
Mailing address
3901 Rainbow Blvd
Mail Stop 4004
Kansas City, KS 66103-2937
Phone (913) 588-6364
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100445690C | Medicaid | KS | |
| 205970106 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-34064 | KS | MD | Pediatrics Physician |
| 2002029455 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1689623183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD",
"address_2": "MAIL STOP 4004",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661032937",
"telephone_number": "913-588-6364",
"fax_number": "913-588-6338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD",
"address_2": "MAIL STOP 4004",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661032937",
"telephone_number": "913-588-6364",
"fax_number": "913-588-6338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEYDERT",
"first_name": "JOY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2002029455",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "04-34064",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100445690C",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205970106",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.