Kimberly Shaffer Weatherby

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2479 Aloma Ave
Winter Park, FL 32792-2541

Phone

(407) 657-6692

Fax

(407) 894-6010

NPI assigned

Oct 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kimberly Shaffer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1811207095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2479 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922541",
            "telephone_number": "407-657-6692",
            "fax_number": "407-894-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922541",
            "telephone_number": "407-657-6692",
            "fax_number": "407-894-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERBY",
        "first_name": "KIMBERLY",
        "middle_name": "SHAFFER",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SHAFFER",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenna Leigh Watson
• Max S Watzman, DO
• Wave Counseling and Consulting Services
• Zachary Way
• Amanda Kelli Wazbinski
• Peyton Webb
• Sarah Anne Collier Webb, LCSW
• Ashlee Weber, PMHNP
• Caitlyn Weber
• Rebecca L Weber, M.D.

• Mental Health Counselor in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.