Active NPI
Clifford F Weller, D.O.
- Psychiatry Physician
- Wellsboro, PA
National Provider Identifier
1699705269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS011058L
- Practice address
- 32-36 Central Ave
Wellsboro, PA 16901-1840 - Phone
- (570) 723-0340
- Fax
- (570) 723-8087
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OS011058L | PA | Primary |
Addresses
Primary practice location
32-36 Central Ave
Wellsboro, PA 16901-1840
Mailing address
32-36 Central Ave
Wellsboro, PA 16901-1840
Phone (570) 723-0340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018551790001 | Medicaid | PA |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3833 | TN | MD | Physical Therapist |
Interoperability endpoints
- cweller156709@direct-guthrie.org
- clifford.weller@hca5.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1699705269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32-36 CENTRAL AVE",
"city": "WELLSBORO",
"state": "PA",
"postal_code": "169011840",
"telephone_number": "570-723-0340",
"fax_number": "570-723-8087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32-36 CENTRAL AVE",
"city": "WELLSBORO",
"state": "PA",
"postal_code": "169011840",
"telephone_number": "570-723-0340",
"fax_number": "570-723-8087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "CLIFFORD",
"middle_name": "F",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OS011058L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018551790001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wellsboro, PA
- Denielle L Watson
- Courtney Lynn Wattles, OTR/L
- Beth Weaver, CRNP
- Weis Markets Inc
- Well Adjusted Chiropractic Center PC
- Wellsboro Area School District
- Wellsboro Firemens Ambulance Association Inc
- Wellsboro Healthcare and Rehabilitation LLC
- Wellsboro Imaging Inc
- Wellsboro Pediatric Health Care Associates
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.