Active NPI
Mary Melinda Weakley, MD
- Psychiatry Physician
- Bloomington, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01041728A
- Practice address
- 350 S Landmark Ave
Bloomington, IN 47403 - Phone
- (812) 332-9874
- Fax
- (812) 335-7604
- NPI assigned
- Feb 3, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 01041728A | IN | |
| Psychiatry Physician | 2084P0800X | 01041728A | IN | Primary |
Addresses
Primary practice location
350 S Landmark Ave
Bloomington, IN 47403
Mailing address
350 S Landmark Ave
Bloomington, IN 47403-5001
Phone (812) 332-9874
Other practice location 1
103 Willow St
Nashville, IN 47448-7604
Phone (812) 988-2231
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200110220A | Medicaid | IN |
Other names 1
- Mindy Weakley
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MWEAKLEY@direct.iuhealth.org | ||
| Direct Messaging Address | MWEAKLEY@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01041728A | IN | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group Riley Specialists, LLC | Current | Accepting new patients | |
| Indiana University Health Southern Indiana Physicians, LLC | Current | Accepting new patients | |
| Indiana University Health Southern Indiana Physicians LLC | Current | Accepting new patients | |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Locations
350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874
601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
103 Willow St
Nashville, IN 47448
Phone (812) 988-2231
Interoperability endpoints
- mweakley@direct.iuhealth.org
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
-
- Pediatrics Physician
- Indianapolis, IN
- NPI 1699561480
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Durable Medical Equipment & Medical Supplies
- Bloomington, IN
- NPI 1063179844
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1801868989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 S LANDMARK AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474035001",
"telephone_number": "812-332-9874",
"fax_number": "812-335-7604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 S LANDMARK AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47403",
"telephone_number": "812-332-9874",
"fax_number": "812-335-7604"
}
],
"practiceLocations": [
{
"address_1": "103 Willow St",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "IN",
"postal_code": "474487604",
"country_code": "US",
"telephone_number": "812-988-2231",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEAKLEY",
"first_name": "MARY",
"middle_name": "MELINDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IN",
"license": "01041728A",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01041728A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200110220A",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MWEAKLEY@direct.iuhealth.org",
"affiliation": "N",
"address_1": "350 S Landmark Ave",
"city": "Bloomington",
"state": "IN",
"country_code": "US",
"postal_code": "47403",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MWEAKLEY@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "103 Willow St",
"city": "Nashville",
"state": "IN",
"country_code": "US",
"postal_code": "474487604",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MINDY",
"last_name": "WEAKLEY",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.