Jennifer Weatherly, D.O. P.a

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JENNIFER WEATHERLY, D.O. P.A

Practice address

3250 W Pleasant Run Rd Ste 160
Lancaster, TX 75146-1071

Phone

(972) 274-5200

Fax

(972) 274-5217

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Andrea Weatherly, D.O.

Title

Physician/Owner

Phone

(972) 274-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grandview Medical Center Other name

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1982614715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W PLEASANT RUN RD STE 160",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461071",
            "telephone_number": "972-274-5200",
            "fax_number": "972-274-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W PLEASANT RUN RD STE 160",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461071",
            "telephone_number": "972-274-5200",
            "fax_number": "972-274-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER WEATHERLY, D.O. P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "WEATHERLY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANDREA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "972-274-5200",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0076KT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandview Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Unaleshia Jackson, LPC
• Ebone Jahi-Coley
• Latasha James, SLP-A
• Jay Davis Enterprise LLC (Jimmie Davis)
• Jennifer Weatherly D.O.P.a.
• Jennifer Weatherly, D.O., P.a.
• Frederica Johnson
• Geninice Johnson, BA, LCDC-I
• George Mitchel Johnson
• Lataurus Johnson

• Family Medicine Physician in Lancaster, TX
• Providers in Lancaster, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.