Philip Aaron Weatherford, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1129757 Issued in TN

Practice address

3 Sheridan SQ
Kingsport, TN 37660-7390

Phone

(423) 392-6840

NPI assigned

Mar 9, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: philip.weatherford.p1@direct.aak.nextgenshare.com

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.

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  • NPI 1750434619
  Medicare reassignment

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790226728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHERIDAN SQ",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607390",
            "telephone_number": "423-392-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHERIDAN SQ",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607390",
            "telephone_number": "423-392-6840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Broyles Dr",
            "address_2": "Suite #2",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376012532",
            "country_code": "US",
            "telephone_number": "423-282-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERFORD",
        "first_name": "PHILIP",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-09",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1129757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.weatherford.p1@direct.aak.nextgenshare.com",
            "affiliation": "N",
            "address_1": "3 Sheridan Sq",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376607390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Myra Watts, FNP
• Alia Way, PA-C
• Marta Jean Wayt, DO
• Jeffrey S Weatherall, MD
• Susie Weatherall, OTR/L
• Robert Keltner Weatherly III, BSW
• Rebekah C Weaver, NP
• Harold J Webb, MD
• Katrina Lorraine Webb, FNP
• Sarah Arroyo Webb, PHARMD

• Physician Assistant in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.