Individual provider Active NPI

Debra A Weimerskirch, MD

  • Pediatrics Physician
  • Saint Paul, MN
National Provider Identifier
1770556193
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38583 Issued in MN
Practice address
345 North Smith Avenue
Children's Hospitals and Clinics Emergency Physicians
St. Paul, MN 55102-2346
Phone
(651) 220-6914
Fax
(651) 220-6999
NPI assigned
Feb 8, 2006
Last updated
Aug 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 38583 MN Primary

Addresses

Primary practice location

345 North Smith Avenue
Children's Hospitals and Clinics Emergency Physicians
St. Paul, MN 55102-2346

Mailing address

2910 Centre Pointe Dr
35-121A
Roseville, MN 55113-1182
Phone (651) 855-2327

Other identifiers 1

IdentifierTypeStateIssuer
328911700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140131000901 MN Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1658500293 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38583MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health Care CurrentSince Feb 1, 2015 Accepting new patients
Emergency Care Consultants, PA CurrentSince Sep 1, 2018 Accepting new patients
Childrens Health Care CurrentSince Feb 1, 2015 Accepting new patients
Childrens Health Care Pediatrics Current Accepting new patients
Pediatric Surgical Associates LTD Past Accepting new patients
Central Pediatrics, P.a. Past Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1770556193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DR",
            "address_2": "35-121A",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131182",
            "telephone_number": "651-855-2327",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NORTH SMITH AVENUE",
            "address_2": "CHILDREN'S HOSPITALS AND CLINICS EMERGENCY PHYSICIANS",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551022346",
            "telephone_number": "651-220-6914",
            "fax_number": "651-220-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIMERSKIRCH",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "38583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328911700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.