Individual provider Active NPI

Mary Virginia Deary-Weiss, APRN

  • Adult Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1699415299
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1050972 Issued in FL
Practice address
5501 4TH St N
St Petersburg, FL 33703-2251
Phone
(727) 327-0333
NPI assigned
Mar 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1050972 FL Primary

Addresses

Primary practice location

5501 4TH St N
St Petersburg, FL 33703-2251

Mailing address

242 1176TH Terr Dr East
Redington Shores, FL 33708
Phone (813) 967-3416

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1050972FLMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1699415299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 1176TH TERR DR EAST",
            "city": "REDINGTON SHORES",
            "state": "FL",
            "postal_code": "33708",
            "telephone_number": "813-967-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337032251",
            "telephone_number": "727-327-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARY-WEISS",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "1050972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.