Individual provider Active NPI

Donald A Weller, M.D.

  • Gastroenterology Physician
  • Maysville, KY
National Provider Identifier
1861490740
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
34725 Issued in KY
Practice address
991 Medical Park Dr
Maysville, KY 41056-8764
Phone
(606) 759-5157
Fax
(606) 759-5582
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 34725 KY Primary

Addresses

Primary practice location

991 Medical Park Dr
Maysville, KY 41056-8764

Mailing address

991 Medical Park Dr Ste 203
Maysville, KY 41056-8728
Phone (606) 759-5157

Other identifiers 1

IdentifierTypeStateIssuer
64001709MedicaidKY

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
I20061222000200 KY Practitioner - Gastroenterology 6507866555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Boston University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

989 Medical Park Dr
Maysville, KY 41056-8750
Phone (606) 759-3585

991 Medical Dr
Suite 207
Maysville, KY 41056-8728
Phone (606) 759-4852

991 Medical Park Dr
Maysville, KY 41056-8728

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy145
Upper gastrointestinal (GI) endoscopy for acid reflux86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34725KYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadowview Physician Practice, LLC CurrentSince Apr 1, 2015 Accepting new patients
Meadowview Physician Practice LLC CurrentSince Apr 1, 2015 Accepting new patients
Meadowview Physician Practice LLC Past Accepting new patients

Locations

991 Medical Park Dr
Ste 201
Maysville, KY 41056
Phone (606) 759-3585

991 Medical Park Dr
Ste 202
Maysville, KY 41056
Phone (606) 759-5424

991 Medical Park Dr
Ste 203
Maysville, KY 41056
Phone (606) 759-4869

Interoperability endpoints

  • Direct secure messaging: donald.weller.1@19475.direct.athenahealth.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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861490740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 MEDICAL PARK DR STE 203",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568728",
            "telephone_number": "606-759-5157",
            "fax_number": "606-759-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 MEDICAL PARK DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568764",
            "telephone_number": "606-759-5157",
            "fax_number": "606-759-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "DONALD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "34725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64001709",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.