Sandra Lou Weatherly

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT84336 Issued in TX

Practice address

900 8TH Ave
Fort Worth, TX 76104-3902

Phone

(817) 347-1406

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Catholic Health Initiatives Colorado

  dba St Mary Corwin Health Promotions Center Rehab

  • Physical Therapist
  • Pueblo, CO
  • NPI 1912107491
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1881775930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043902",
            "telephone_number": "817-347-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043902",
            "telephone_number": "817-347-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3207 N Academy Blvd",
            "address_2": "No. 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809175100",
            "country_code": "US",
            "telephone_number": "719-776-3600",
            "fax_number": "719-776-3610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERLY",
        "first_name": "SANDRA",
        "middle_name": "LOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT84336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WCB Medical Center LLC (First Choice Emergency Room)
• WCHS of Texas (Hemphill Treatment Facility)
• We Are Star Specimen Collectors, LLC (Caroline Smith)
• Eric Scott Wear, DDS
• Amy Weatherly
• Valarie Weathersby
• Heather Weatherspoon
• Whitney Weatherspoon, FNP-BC
• Angela Christine Weaver, LCSW
• Cherry Louise Weaver

• Registered Dietitian in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.