Individual provider Active NPI

Lesley Marie Weghorn, MD

  • Pediatrics Physician
  • Edgewood, KY
National Provider Identifier
1821050717
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39485 Issued in KY
Practice address
830 Thomas More Pkwy
Suite 200 a
Edgewood, KY 41017-5102
Phone
(859) 341-3383
Fax
(859) 578-2013
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39485 KY Primary

Addresses

Primary practice location

830 Thomas More Pkwy
Suite 200 a
Edgewood, KY 41017-5102

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 341-3383

Other identifiers 2

IdentifierTypeStateIssuer
259640MedicaidOH
64103013MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050715000272 KY Practitioner - Pediatric Medicine 4880620335 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Feb 13, 2011 Accepting new patients
Summit Medical Group, Inc Pediatrics CurrentSince Feb 13, 2011 Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients

Locations

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

830 Thomas More Pkwy
Ste 200A
Edgewood, KY 41017
Phone (859) 301-8686

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: lweghorn2860@direct-prd.stelizabeth.com

Organizations & group practices 3

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1821050717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-341-3383",
            "fax_number": "859-578-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 THOMAS MORE PKWY",
            "address_2": "SUITE 200 A",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175102",
            "telephone_number": "859-341-3383",
            "fax_number": "859-578-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGHORN",
        "first_name": "LESLEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259640",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64103013",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.