DR. MARK W WEATHERLY (NPI# 1144223553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144223553 |
| Entity Type | Individual |
| Full Name | DR. MARK W WEATHERLY |
| Credential | MD |
| Practice Address |
7695 Poplar Pike Suite 101 Germantown TN 38138-5947 |
| Mailing Address |
7695 Poplar Pike Suite 101 Memphis TN 38138-5947 |
| Practice Telephone | 9016852696 |
| Mailing Telephone | 9016852696 |
| Mailing Fax Number | 9016829747 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2016-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
12841 | TN | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
10958 | MS | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
12841 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3046111 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881703650 | Mark Richard Weatherly | Pediatrics | 60 W Gore Street, Orlando, FL 32806-1101 | 2006-08-29 |
| Street Address |
7695 POPLAR PIKE SUITE 101 |
| City | GERMANTOWN |
| State | TN |
| Zip Code | 38138-5947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920394 | Jennifer R Boals | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-23 |
| 1437324118 | Ernest Schorr Behnke | Radiology | 7695 Poplar Pike, Germantown, TN 38138-5947 | 2008-04-24 |
| 1003088113 | Joseph Patrick Blankinship Jr. | Radiology | 7695 Poplar Pike, Germantown, TN 38138-5947 | 2008-03-28 |
| 1689897563 | Kevin Michael Garrett | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2007-04-10 |
| 1528018686 | Francis Daniel Donovan Jr. | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2006-05-11 |
| 1972506384 | Brixey R Shelton | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-31 |
| 1831192285 | Philip R Weber | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-31 |
| 1083617492 | William E Routt Jr. | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-31 |
| 1538162946 | Sidney D Selvidge | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-31 |
| 1669475067 | Robert Yarbrough | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382281 | Bluff Medical Group | Nurse Practitioner | 1779 Kirby Parkway, Suite 1-212, Germantown, TN 38138 | 2020-10-07 |
| 1689293797 | Diana Bryn Manning | Dietitian, Registered | 7705 Poplar Ave., Medical Office B, Suite 150, Germantown, TN 38138 | 2020-04-09 |
| 1386102796 | Moscow Group LLC | Pharmacy | 2013 Exeter Rd, Germantown, TN 38138 | 2019-03-05 |
| 1952811010 | Select | Counselor | 9045 Forest Centre Dr Ste 102, Germantown, TN 38138 | 2017-10-03 |
| 1033638994 | 901 Physical Therapy, Pllc | Physical Therapist | 2495 Regents Walk, Germantown, TN 38138 | 2017-09-12 |
| 1124552401 | Elite Dental Germantown Plc | Dentist | 9064 Corporate Gradens Drive, Germantown, TN 38138 | 2017-04-13 |
| 1740728880 | Christian C Haynes | Nurse Anesthetist, Certified Registered | 1900 Exeter Rd., Suite 210, Germantown, TN 38138 | 2017-02-09 |
| 1740644004 | Kimberly Brooke Scheidegger | Counselor | 9045 Forest Centre Way, Heartlife Professional Soul Care, Germantown, TN 38138 | 2016-04-12 |
| 1427411644 | Jimmy Tam Tran | Internal Medicine | 7550 Wolf River Blvd., Ste. 102, Germantown, TN 38138 | 2016-04-04 |
| 1952761876 | Jane Chin Wynn Yeoh | Orthopaedic Surgery | 1400 South Germantown Road, Germantown, TN 38138 | 2016-03-04 |
| Find all providers in zip 38138 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760820625 | John Dalton Braun | Radiology | 7600 Wolf River Blvd Ste 200, Germantown, TN 38138 | 2013-06-12 |
| 1184859589 | Akemi Miller | Radiology | 20410 Observation Dr Ste 104, Germantown, MD 20876 | 2009-05-29 |
| 1679507883 | Center for Medical Imaging Inc | Radiology | W178n9912 Rivercrest Dr, Suite 102, Germantown, WI 53022-4645 | 2006-07-11 |
| 1639478837 | Chika C Obele | Radiology | 7945 Wolf River Blvd, Germantown, TN 38138-1762 | 2011-03-28 |
| 1851559223 | William Xuan Nghiem | Radiology | 20410 Observation Drive, Suite 104, Germantown, MD 20876-3201 | 2008-06-01 |
| 1144291022 | Zahide Erkmen | Radiology | 20410 Observation Dr, Suite 104, Germantown, MD 20876-4000 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487277042 | Via Institutes Pllc | Radiology | 8886 Classic Dr, Memphis, TN 38125-8839 | 2020-05-18 |
| 1609334713 | Paul Wooten | Radiology | 1729 Curie St, Alcoa, TN 37701-1700 | 2019-03-07 |
| 1295112498 | David R Zielske | Radiology | 839 Treemont Ct, Nashville, TN 37220-1536 | 2015-04-27 |
| 1942551270 | Sam J Williams IIi | Radiology | 1610 Shore View Ln, Hixson, TN 37343-4646 | 2012-09-26 |
| 1144485418 | Vijaykumar Agrawal | Radiology | 865 Jefferson Avenue Department of Radiology, F150 Chandler, Memphis, TN 38163-0001 | 2008-07-25 |
| 1780618942 | Tennessee Phlebology PC | Radiology | 9020 Overlook Blvd Ste 150, Brentwood, TN 37027-2727 | 2006-07-11 |
| 1104883966 | Jason Glen Funderburk | Radiology | 116 Concord Rd, Suite 500, Knoxville, TN 37934-2940 | 2006-04-27 |
| 1851865794 | Zeni Interventional Pllc | Radiology | 6126 Poplar Ave, Memphis, TN 38119-4710 | 2019-01-14 |
| 1841799707 | Southern Pain and Regenerative Medicine PC | Radiology | 176 Briarwood St Ste B, Camden, TN 38320-1456 | 2018-02-06 |
| 1326564972 | Association of University Radiologists, PC | Radiology | 101 Professional Park Pvt Dr, Colonial Heights, TN 37663-2288 | 2017-08-16 |
| Find all providers with the same taxonomy | ||||
| City | GERMANTOWN |
| Zip Code | 38138 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.