Mickey Ray Weimer, C.F.A.

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

97391 Issued in ID

Practice address

323 E. Riverside Dr #234
Eagle, ID 83616

Phone

(208) 938-4080

Fax

(208) 938-8922

NPI assigned

Nov 17, 2006

Last updated

Oct 14, 2014By the provider in NPPES

Sex

Male

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

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1942373766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 W LONESOME DOVE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836468271",
            "telephone_number": "208-724-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E. RIVERSIDE DR #234",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "83616",
            "telephone_number": "208-938-4080",
            "fax_number": "208-938-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "MICKEY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "C.F.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "ID",
            "license": "97391",
            "primary": true
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "NU",
            "license": "97391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Wallner, SLP
• Danielle Walther
• Kristen Germain Ware, LPC
• Aaron J. Warner, O.D.
• Jessica Watson, NP
• Ashlynn Breanne Welch, MA
• Well Rooted Integrative Therapy PLLC
• Wellness Impact Nutrition, LLC
• Julie Wells, M.S.
• Wellspring Behavioral Health, Inc

• Surgical Technologist in Eagle, ID
• Providers in Eagle, ID by specialty
• Surgical Technologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.