Active NPI
Ronald Gene Weakley, MD
- Obstetrics & Gynecology Physician
- Modesto, CA
National Provider Identifier
1730136011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- C36554
- Practice address
- 1401 Spanos CT
Ste 124
Modesto, CA 95355-2814 - Phone
- (209) 525-3883
- Fax
- (209) 525-3889
- NPI assigned
- May 30, 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | C36554 | CA | Primary |
Addresses
Primary practice location
1401 Spanos CT
Ste 124
Modesto, CA 95355-2814
Mailing address
1401 Spanos CT
Ste 124
Modesto, CA 95355-2814
Phone (209) 525-3883
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C365540 | Medicaid | CA |
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 |
|---|---|---|---|
| 36554 | CA | MD | Pharmacist |
| C36554 | CA | MD | Obstetrics & Gynecology Physician |
Interoperability endpoints
- rweakley59792@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1730136011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 SPANOS CT",
"address_2": "STE 124",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552814",
"telephone_number": "209-525-3883",
"fax_number": "209-525-3889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 SPANOS CT",
"address_2": "STE 124",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552814",
"telephone_number": "209-525-3883",
"fax_number": "209-525-3889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAKLEY",
"first_name": "RONALD",
"middle_name": "GENE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "C36554",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C365540",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.