MATHEW BENJAMIN WEIMER MD
Complete NPI Record 1245444074
Family Medicine in Milton, WV
Active since May 10, 2007PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Mathew Benjamin Weimer, MD (NPI 1245444074), an individual family medicine provider in Milton, WV. All 42 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1245444074 Field 1/42
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/42
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: WEIMER Field 3/42
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: MATHEW Field 4/42
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: BENJAMIN Field 5/42
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: MD Field 6/42
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: PO BOX 1680 Field 7/42
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: HUNTINGTON Field 8/42
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: WV Field 9/42
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 257171680 Field 10/42
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/42
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3047815159 Field 12/42
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 3045238115 Field 13/42
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 220 JOHNS CREEK ROAD Field 14/42
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: MILTON Field 15/42
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: WV Field 16/42
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 255411513 Field 17/42
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/42
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3047431407 Field 19/42
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 3047434516 Field 20/42
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 23/42
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 207Q00000X Field 24/42
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 35.091875 Field 25/42
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: OH Field 26/42
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 27/42
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 207Q00000X Field 28/42
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 22530 Field 29/42
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: WV Field 30/42
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 31/42
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 3810012382 Field 32/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 33/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: WV Field 34/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 2: 2849092 Field 35/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 05 Field 36/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: OH Field 37/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 3: 7100228730 Field 38/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 3: 05 Field 39/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 3: KY Field 40/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 41/42
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 29
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
408 Alexander St
Location 1/29Cedar Grove, WV 25039 · Phone (304) 595-1770 · Fax (304) 595-3298
85 Donohoe Dr
Location 2/29Huntington, WV 25705-8887 · Phone (304) 399-3310
2908 Auburn Rd
Location 3/29Huntington, WV 25704-2715 · Phone (304) 781-5800 · Fax (304) 781-5504
1100 Hospital Dr
Location 4/29Hurricane, WV 25526-8712 · Phone (304) 757-8803 · Fax (304) 757-8684
111 Great Teays Blvd Ste 101
Location 5/29Scott Depot, WV 25560-9548 · Phone (304) 757-8803 · Fax (304) 757-6904
3 Adena Dr
Location 6/29Kermit, WV 25674-8063 · Phone (304) 393-4090 · Fax (304) 393-4091
1 Timberwolf Ln
Location 7/29Huntington, WV 25704-9377 · Phone (304) 429-1764 · Fax (304) 429-1746
930 2nd St
Location 8/29Huntington, WV 25701-3146 · Phone (304) 528-2070 · Fax (304) 529-3026
723 9th Ave
Location 9/29Huntington, WV 25701-2718 · Phone (304) 529-0645 · Fax (304) 529-3026
2801 Jackson Ave
Location 10/29Point Pleasant, WV 25550-1713 · Phone (304) 675-4107 · Fax (304) 675-4233
2501 Jackson Ave
Location 11/29Point Pleasant, WV 25550-2035 · Phone (304) 857-0004 · Fax (304) 857-0005
4270 US Route 60
Location 12/29Huntington, WV 25705-2936 · Phone (304) 781-5001 · Fax (304) 781-5002
42 McGinnis Dr
Location 13/29Wayne, WV 25570-9553 · Phone (304) 272-5136 · Fax (304) 272-6261
100 Pioneer Rd
Location 14/29Wayne, WV 25570-9504 · Phone (304) 272-3783 · Fax (304) 272-3807
540 10th St
Location 15/29Huntington, WV 25701-2217 · Phone (304) 399-3366 · Fax (304) 522-0091
1630 13th Ave
Location 16/29Huntington, WV 25701-3812 · Phone (304) 697-2014 · Fax (304) 697-2017
2300 US Route 60
Location 17/29Ona, WV 25545-9712 · Phone (304) 743-7495 · Fax (304) 743-6660
3377 US Route 60
Location 18/29Huntington, WV 25705-2837 · Phone (304) 399-3310 · Fax (304) 523-5416
6350 US Route 60 E
Location 19/29Barboursville, WV 25504-1232 · Phone (304) 399-3350 · Fax (304) 955-5047
71 Wayne St
Location 20/29Fort Gay, WV 25514-8518 · Phone (304) 648-5544 · Fax (304) 648-5989
19867 Huntington Rd
Location 21/29Gallipolis Ferry, WV 25515-6610 · Phone (304) 675-5725 · Fax (304) 675-5727
22 Fleming Dr
Location 22/29Harts, WV 25524-9788 · Phone (304) 855-4595 · Fax (304) 855-9377
1246 McClellan Hwy
Location 23/29Harts, WV 25524-9524 · Phone (304) 310-1246 · Fax (304) 310-1248
2585 3rd Ave
Location 24/29Huntington, WV 25703-1642 · Phone (304) 781-5138 · Fax (304) 781-5139
1301 Hal Greer Blvd
Location 25/29Huntington, WV 25701-3803 · Phone (304) 525-0572 · Fax (304) 529-1119
1 Highlander Way
Location 26/29Huntington, WV 25701-5261 · Phone (304) 528-6445 · Fax (304) 528-5220
3729 Teays Valley Rd Ste 100
Location 27/29Hurricane, WV 25526-9705 · Phone (304) 760-6040 · Fax (304) 760-6042
4407 MacCorkle Ave SE Ste 2
Location 28/29Charleston, WV 25304-2541 · Phone (304) 925-0392 · Fax (304) 925-0396
864 Oakwood Rd
Location 29/29Charleston, WV 25314-2010 · Phone (304) 352-1191 · Fax (681) 265-5161
Other Provider Identifiers 3
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
3810012382 Medicaid
Identifier 1/3State: WV
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
2849092 Medicaid
Identifier 2/3State: OH
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
7100228730 Medicaid
Identifier 3/3State: KY
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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