Gwen Weller · Pediatrics Physician

3650 Express Dr, Shallotte, NC 28470-6501

Overview

Gwen Weller is a Pediatrics Physician practicing in Shallotte, North Carolina. The National Provider Identifier (NPI) is #1134062441, which was assigned on April 11, 2026, and the registration record was last updated on April 11, 2026. The practitioner's main practice location is at 3650 Express Dr, Shallotte, NC 28470-6501; the contact telephone number is 9107542229, and the fax number is 9107542217. The primary taxonomy of Gwen Weller is Pediatrics Physician (208000000X). Gwen Weller is licensed to practice in the state of North Carolina (#5024174).

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Provider Information

NPI 1134062441
Entity Type Individual
Provider Name GWEN WELLER
Gender Female
Credential FNP-C
Practice Address 3650 Express Dr
Shallotte
NC 28470-6501
Practice Telephone 9107542229
Practice Fax Number 9107542217
Mailing Address 3650 Express Dr
Shallotte
NC 28470-6501
Mailing Telephone 9107542229
Mailing Fax Number 9107542217
Certification Date 2026-04-11
Enumeration Date 2026-04-11
Last Update Date 2026-04-11
Is Sole Proprietor N

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y208000000XPediatrics5024174NC

Taxonomy Information

Primary Taxonomy

Code 208000000X
Taxonomy Pediatrics Physician
Classification Pediatrics
Grouping Allopathic & Osteopathic Physicians
Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Children's Healthcare Center, LLC 510 Washington Ave, Sandersville, GA 31082-1971Pediatrics Physician2026-04-10
Children's Dentistry of Lithonia LLC 7215 Stonecrest Pkwy, Lithonia, GA 30038-2563Pediatrics Physician2026-03-26
Stonewall Pediatric Health Center, LLC 1303 S. Unversity Dr, Nacogdoches, TX 75961Pediatrics Physician2026-04-09
Randolph Forbes Wykoff · Randy Wykoff 206 Lake Meadow Dr, Johnson City, TN 37615-4015Pediatrics Physician2026-03-28
James M Landers Md Plc 20825 Mack Ave, Grosse Pointe Woods, MI 48236-1485Pediatrics Physician2026-04-06
Everkind Pediatrics 31717 Tradewinds Dr, Avon Lake, OH 44012-2915Pediatrics Physician2026-04-03
Emerald Home Health LLC 8301 White Pine Dr, Fort Worth, TX 76123-1702Pediatrics Physician2026-03-26
Atlee Lambert 2800 S 2nd St Ste B, Cabot, AR 72023-7030Pediatrics Physician2026-04-11
Twilight Pediatric Medicine 440 Asbury Rd, Freeville, NY 13068-9740Pediatrics Physician2026-03-31
Giorgi Maziashvili 450 Chew St Ste 203, Allentown, PA 18102-3434Pediatrics Physician2026-04-09
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Location Information

Street Address 3650 EXPRESS DR
City SHALLOTTE
State NC
Zip Code 28470-6501
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Madisyn Creekmore 3650 Express Dr, South Brunswick, NC 28470-6501Physician Assistant2025-10-16

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Kierra Christina Elizabeth Smith 5272 Ocean Hwy W, Shallotte, NC 28470-4006Physician Assistant2024-12-25
Faith Farris 5272 Ocean Hwy W, Shallotte, NC 28470-4006Physician Assistant2024-07-09
Blake Family Medicine PLLC 4704 Main St, Shallotte, NC 28470-1880Physician Assistant2007-04-12
Growth & Healing Center PLLC 117 Holden Beach Rd Sw Ste 109, Shallotte, NC 28470-1787Clinical Social Worker2025-06-09
Ashlee Michelle Wood 5145 Sellers Rd, Shallotte, NC 28470-3405Family Nurse Practitioner2025-06-10
Family Medical Supply LLC 4600 Main St Ste 12, Shallotte, NC 28470-1899Parenteral & Enteral Nutrition Supplies (DME)2006-09-14
Tanya Faye Bush · Tanya Faye Duncan 512 Village Rd Ste 104, Shallotte, NC 28470-3409Nurse Practitioner2015-08-11
Jordan Ryley Krumanocker 5145 Sellers Rd, Shallotte, NC 28470-3405Pharmacist2024-08-17
Allied Home Health Care, Inc. 143 Holden Beach Rd, 1a, Shallotte, NC 28470-1917Nursing Care Agency2008-05-08
Michal Krzysztof Szelwach 5160 Ocean Hwy W, Shallotte, NC 28470-4012Physician Assistant2021-11-30
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Similar Providers

Providers with similar names

Provider NameAddressTaxonomyEnumeration Date
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Gwen Katherine Gostomski · Gwen Katherine Stokes 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5503Dentist2024-07-08
Segolene Weller 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970Student in an Organized Health Care Education/Training Program2017-04-05
Sarah Gwen Goaslind Parkin 4318 Trail Boss Dr Ste 100, Castle Rock, CO 80104-7512Family Medicine Physician2022-04-09
Hilary Weller 601 Norland Ave Ste 100, Chambersburg, PA 17201-4235Family Nurse Practitioner2019-09-06
Diane Gwen Bloor-Biersach 6040 W Lisbon Ave, Milwaukee, WI 53210-2116Counselor2006-07-21
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.