Antwonette Miriam Weston

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

1005 Gilmore St
Waycross, GA 31501-2147

Phone

(706) 386-7506

NPI assigned

Oct 12, 2024

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

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": "1728691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1922828136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 GILMORE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315012147",
            "telephone_number": "706-386-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 GILMORE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315012147",
            "telephone_number": "706-386-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON",
        "first_name": "ANTWONETTE",
        "middle_name": "MIRIAM",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-12",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waycross Family Pharmacy
• Waycross Family Practice
• Waycross Orthopaedics, P.C.
• Waycross Urology Clinic PC
• Kelly Beth Weber, M.ED., CCC-SLP
• Iona Virginia Weston
• Benjamin Randolph Wheeler, R.PH.
• George A Wheeler, M.D.
• Theresa Wheeler, LPN
• Ashley Nicole White, FNP-C

• Community/Behavioral Health Agency in Waycross, GA
• Providers in Waycross, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.