Amy R Weidman MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AMY R WEIDMAN MD LLC

Practice address

3610 W Market St
Ste 108
Fairlawn, OH 44333-9301

Phone

(330) 836-2828

Fax

(330) 836-0959

NPI assigned

Feb 20, 2017

Last updated

Feb 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amy R. Weidman, MDNPI 1235143165

Title

Owner/Authorized Official

Phone

(330) 836-2828

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy R Weidman, M.D.

  • Internal Medicine Physician
  • Akron, OH
  • NPI 1235143165
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1770022089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 W MARKET ST",
            "address_2": "STE 108",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339301",
            "telephone_number": "330-836-2828",
            "fax_number": "330-836-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 W MARKET ST",
            "address_2": "STE 108",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339301",
            "telephone_number": "330-836-2828",
            "fax_number": "330-836-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY R WEIDMAN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "WEIDMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "330-836-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.