Paul Weigle, PA
Individual provider Active NPI Physician Assistant · Willard, UT
NPI 1750071767 · NPPES record last updated Nov 1, 2024
Key facts
- NPI
- 1750071767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 14184833-1206 (UT)
- Practice address
- 96 S 100 W
Willard, UT 84340-9764 - Phone
- (435) 740-9314
- NPI assigned
- May 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241211003397 | UT | Practitioner - Physician Assistant | 6406382613 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14184833-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coronado Wellness LLC | Current |
Accepting new patients | |
| Whole Mind LLC | Current |
Accepting new patients | |
| Neuro Wellness Utah, LLC | Past | Accepting new patients |
Locations
770 S 200 E
Ste 103
Brigham City, UT 84302
1412 S Legend Hills Dr
Ste 110
Clearfield, UT 84015
584 E 12300 S
Draper, UT 84020
11576 S State St
Ste 202
Draper, UT 84020
Phone (801) 960-9355
3500 Harrison Blvd
Ste 200
Ogden, UT 84403
Phone (801) 627-2225
1221 S Valley Grove Way
Ste 160
Pleasant Grove, UT 84062
Phone (801) 447-7189
333 W 2230 N
Ste 225
Provo, UT 84604
Phone (385) 223-8862
3507 N University Ave
Ste 225
Provo, UT 84604
Phone (801) 491-0222
8789 S Highland Dr
Ste 300
Sandy, UT 84093
Phone (385) 787-1550
770 E 800 N Ste 772
Spanish Fork, UT 84660
1220 N Main St
Ste 11
Springville, UT 84663
Phone (801) 361-0982
4293 S 2700 W
Taylorsville, UT 84129
Phone (385) 308-8750
323 N Main St
Tooele, UT 84074
Phone (435) 233-7900
Interoperability endpoints
- paul.weigle.1@33637.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 14184833-1206 | UT | Yes |
Addresses
Primary practice location
96 S 100 W
Willard, UT 84340-9764
Mailing address
96 S 100 W
Willard, UT 84340-9764
Other providers in Willard, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.