DEREK SCOTT WEATHERDON (NPI# 1992805626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992805626 |
| Entity Type | Individual |
| Full Name | DEREK SCOTT WEATHERDON |
| Credential | M.D. |
| Practice Address |
107 Airport Rd Kinston NC 28501-1603 |
| Practice Telephone | 2525274146 |
| Practice Fax Number | 2525275697 |
| Mailing Telephone | 2525274146 |
| Mailing Fax Number | 2525275697 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS/NC | 127WE | 01 |
| NC | MEDCOST | A2087 | 01 |
| NC | 89127WE | 05 | |
| NC | UNITED HEALTHCARE | 01-28669 | 01 |
| NC | AETNA | 7736338 | 01 |
| Street Address |
107 AIRPORT RD |
| City | KINSTON |
| State | NC |
| Zip Code | 28501-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528484375 | Lenoir Family Medicine Pa | Non-Pharmacy Dispensing Site | 107 Airport Rd, Kinston, NC 28501-1603 | 2014-03-17 |
| 1033478326 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 107 Airport Rd, Kinston, NC 28501-1603 | 2012-05-08 |
| 1730404880 | Amy Maples Kornegay | Physician Assistant | 107 Airport Rd, Kinston, NC 28501-1603 | 2010-04-01 |
| 1417283268 | Juan R Aviles | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2009-10-29 |
| 1275708687 | Fernando Armando Escabi Mendez | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2008-04-25 |
| 1437250321 | Lenoir Family Medicine, Pa | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2006-09-26 |
| 1871693507 | Joseph Edwards Agsten | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2006-09-23 |
| 1295835924 | Laddie Moore Crisp Jr. | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2006-09-23 |
| 1083714711 | Carlton Andrew Crain | Physician Assistant | 107 Airport Rd, Kinston, NC 28501-1603 | 2006-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912428780 | Latasha Carr | Counselor | 120 Lenoir Str, B, Kinston, NC 28501 | 2017-07-03 |
| 1598295107 | Craig A Marva | Dentist | 1104 West Vernon Ave., Kinston, NC 28501 | 2017-06-15 |
| 1235535238 | Rachel Krueger | Pharmacist | 201 West Vernon Ave, Kinston, NC 28501 | 2014-11-18 |
| 1457773020 | Abigail L Hemmings | Physician Assistant | 2509 North Queen Street, Kinston, NC 28501 | 2014-01-15 |
| 1730521063 | Courtney Mitchell Iv | Dentist | 2500 N Herritage St., Suite A, Kinston, NC 28501 | 2013-07-29 |
| 1023459757 | Courtney Mitchell, IIi Dds Pa | Dentist | 2500 N. Herritage St., Suite A, Kinsten, NC 28501 | 2013-07-10 |
| 1558609602 | Jessica Meria Hendricks | Counselor | 400 Glenwood Ave Ste 2, Kinston, NC 28501 | 2013-01-24 |
| 1871853523 | Bethany Mckittrick Griffin | Pharmacist | 300 North Queen Street, Kinston, NC 28501 | 2012-05-29 |
| 1750647574 | Peter K Hobler | Counselor | 2902 N. Heritage Street, Kinston, NC 28501 | 2012-04-05 |
| 1568732154 | Michael Dion Smallwood | Counselor | 2902 A North Heritage St, Kinston, NC 28501 | 2012-01-12 |
| Find all providers in zip 28501 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538455969 | Med First Immediate Care & Family Practice, Pa | Family Medicine | 2601 N. Herritage Street, Ste. A, Kinston, NC 28501-1502 | 2011-06-23 |
| 1366594293 | Ian Kim | Family Medicine | 2908 N Herritage St, Kinston, NC 28501 | 2007-01-18 |
| 1104884998 | Douglas Elry Watford | Family Medicine | 400 Glenwood Ave, Ste 3, Kinston, NC 28501 | 2006-05-02 |
| 1043211998 | Jennifer Roberson | Family Medicine | 324 N Queen Street, Kinston, NC 28501-4932 | 2005-08-02 |
| 1881041176 | Tambetta Ojong | Family Medicine | 324 N Queen St, Kinston, NC 28501-4932 | 2016-05-17 |
| 1437444155 | Hloy Green | Family Medicine | 324 N Queen St, Kinston, NC 28501-4932 | 2011-06-10 |
| 1417283268 | Juan R Aviles | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2009-10-29 |
| 1578792800 | Martin Dufour | Family Medicine | 324 N Queen St, Kinston, NC 28501-4932 | 2009-07-08 |
| 1275708687 | Fernando Armando Escabi Mendez | Family Medicine | 107 Airport Rd, Kinston, NC 28501-1603 | 2008-04-25 |
| 1023299138 | Lori Collins Scott | Family Medicine | 400 Glenwood Ave, Suite Number 10, Kinston, NC 28501-3851 | 2007-11-16 |
| Find all providers in KINSTON | ||||
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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.