Weese Dermatology PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD167536 Issued in OR

Legal business name

WEESE DERMATOLOGY PC

Practice address

2440 NW Edenbower Blvd
Roseburg, OR 97471-8847

Phone

(541) 957-1141

Fax

(541) 957-1466

NPI assigned

Feb 10, 2015

Organization subpart

No

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

Authorized official

Name

Kaylan L Weese, M.D.NPI 1134449366

Title

Owner

Phone

(541) 957-1141

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kaylan Lawson Weese, M.D.

  • Dermatology Physician
  • Roseburg, OR
  • NPI 1134449366
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine Weber Braunlich, D.O

  • Dermatology Physician
  • Roseburg, OR
  • NPI 1326496522
  Medicare reassignment Care Compare group NPD
• Hannibal Eccles, MD

  • Dermatology Physician
  • Eugene, OR
  • NPI 1770878837
  Medicare reassignment Care Compare group NPD
• Michael Heath, MD

  • MOHS-Micrographic Surgery Physician
  • Roseburg, OR
  • NPI 1437670338
  Medicare reassignment Care Compare group NPD
• Jennifer Ann Brough Wilson, PA

  • Physician Assistant
  • Roseburg, OR
  • NPI 1053714089
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1790176949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718847",
            "telephone_number": "541-957-1141",
            "fax_number": "541-957-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718847",
            "telephone_number": "541-957-1141",
            "fax_number": "541-957-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEESE DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "WEESE",
        "authorized_official_first_name": "KAYLAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-957-1141",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD167536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Webster
• Gabrielle Joan Webster
• Cale Wedell
• Jeremy James Wedge, RN, CNOR, RNFA
• Raven Weeks, FNP
• Joshua Michael Weese, MD
• Kaylan Lawson Weese, M.D.
• Misty Ann Weiser, LSW
• Tania Welikala, LCSW
• James B Wells

• Specialist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.