Andy Michael Weathers, R.T(R), CV

Primary specialty

Cardiovascular-Interventional Technology Radiologic TechnologistTaxonomy code 2471C1101X

License

319217 Issued in MN

Practice address

1054 Vinyard Dr
Oregon, WI 53575-3314

Phone

(608) 250-0550

NPI assigned

Aug 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Andy Michael Fuller Former name

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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1972937795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 VINYARD DR",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753314",
            "telephone_number": "608-250-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 VINYARD DR",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753314",
            "telephone_number": "608-250-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "ANDY",
        "middle_name": "MICHAEL",
        "credential": "R.T(R), CV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C1101X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Cardiovascular-Interventional Technology",
            "state": "MN",
            "license": "319217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "FULLER",
            "middle_name": "MICHAEL",
            "credential": "R.T(R), CV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• University of Wisconsin Medical Foundation Inc
• Susan Carroll Urban, R.N.
• Susana E Valdez-Shogren, RN
• April Volk, LPC
• Walgreen Co
• Kaylin Mary Weber
• Billie Joy Weiss, PTA
• Stacy Williamson
• Erin Winkels
• Christian Andreas Witek, D.D.S.

• All providers in Oregon, WI
• Cardiovascular-Interventional Technology Radiologic Technologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.