Individual provider Active NPI

Kelly J Weyant, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Independence, IA
National Provider Identifier
1821159294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1260 Issued in IA
Practice address
309 1St St E
Independence, IA 50644-2854
Phone
(319) 334-3547
Fax
(319) 334-3781
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1260 IA Primary

Addresses

Primary practice location

309 1St St E
Independence, IA 50644-2854

Mailing address

318 Ridgeview Dr
Independence, IA 50644-3145
Phone (319) 334-3371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1260IAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821159294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 RIDGEVIEW DR",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506443145",
            "telephone_number": "319-334-3371",
            "fax_number": "319-334-3781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 1ST ST E",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506442854",
            "telephone_number": "319-334-3547",
            "fax_number": "319-334-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYANT",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "1260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.