Active NPI
Diane M Weid, N.P.
- Nurse Practitioner
- Chelsea, MI
National Provider Identifier
1760419212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 143379
- Practice address
- 128 Van Buren St
Chelsea, MI 48118-1623 - Phone
- (734) 475-8677
- Fax
- (734) 327-0826
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 143379 | MI | Primary |
Addresses
Primary practice location
128 Van Buren St
Chelsea, MI 48118-1623
Mailing address
PO Box 446
Ann Arbor, MI 48106-0446
Other practice location 1
775 S Main St
Chelsea, MI 48118-1370
Phone (734) 475-1311
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DW143379 | Other | MI | BLUE SHIELD |
| 104425850 | Medicaid | MI |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143379 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epmg of Michigan, P.C. | Nurse Practitioner | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516320000000",
"number": "1760419212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 446",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481060446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 VAN BUREN ST",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181623",
"telephone_number": "734-475-8677",
"fax_number": "734-327-0826"
}
],
"practiceLocations": [
{
"address_1": "775 S Main St",
"address_purpose": "LOCATION",
"city": "Chelsea",
"state": "MI",
"postal_code": "481181370",
"country_code": "US",
"telephone_number": "734-475-1311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEID",
"first_name": "DIANE",
"middle_name": "M",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2018-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "143379",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "DW143379",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104425850",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chelsea, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.