Individual provider Active NPI

Joy A Weydert, M.D.

  • Pediatrics Physician
  • Kansas City, KS
National Provider Identifier
1689623183
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04-34064 Issued in KS
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

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100445690CMedicaidKS
205970106MedicaidMO

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

LicenseStateTypeSpecialty
04-34064KSMDPediatrics Physician
2002029455MOMDPediatrics 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.

Verify at the official NPI Registry.