1457385395 NPI number — CHRISTINE E WEIKERT DPM PC

Table of content: (NPI 1457385395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457385395 NPI number — CHRISTINE E WEIKERT DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTINE E WEIKERT DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NITTANY VALLEY ANKLE & FOOT CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457385395
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1333 S ALLEN ST
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
STATE COLLEGE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16801-5944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-231-0451
Provider Business Mailing Address Fax Number:
814-231-1817

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1333 S ALLEN ST
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-5944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-231-0451
Provider Business Practice Location Address Fax Number:
814-231-1817
Provider Enumeration Date:
07/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WEIKERT
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
814-231-0451

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  SC004314-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: SC004314-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DC1633 . This is a "MEDICARE RR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 130724 . This is a "HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 958D . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7237 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02827700 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: NI146621 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".