Individual provider Active NPI

Weichi Liao, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1811141583
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME111922 Issued in FL
Practice address
6484 Fort Caroline Rd
Jacksonville, FL 32277-2042
Phone
(904) 744-7300
Fax
(904) 722-4271
NPI assigned
Nov 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME111922 FL Primary

Addresses

Primary practice location

6484 Fort Caroline Rd
Jacksonville, FL 32277-2042

Mailing address

6520 Fort Caroline Rd
Jacksonville, FL 32277-2044
Phone (904) 745-3618

Other practice location 1

11513 N Main St
Jacksonville, FL 32218
Phone (904) 751-6200

Other practice location 2

11513 N Main St
Jacksonville, FL 32218
Phone (904) 751-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131121001492 FL Practitioner - Internal Medicine 6901072479 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Apr 15, 2019 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Apr 15, 2019 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 1, 2015 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

11513 N Main St
Jacksonville, FL 32218
Phone (904) 751-6200

12620 Beach Blvd
Ste 13
Jacksonville, FL 32246
Phone (352) 639-0760

1215 Dunn Ave
Jacksonville, FL 32218
Phone (904) 757-1998

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1811141583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772044",
            "telephone_number": "904-745-3618",
            "fax_number": "904-722-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6484 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772042",
            "telephone_number": "904-744-7300",
            "fax_number": "904-722-4271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11513 N Main St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32218",
            "country_code": "US",
            "telephone_number": "904-751-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11513 N Main St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32218",
            "country_code": "US",
            "telephone_number": "904-751-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIAO",
        "first_name": "WEICHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-07",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME111922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.