MEDICARE: JODI MARIE WEEBER RD, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	001966	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001966	OTHER	IA	LICENSURE

General Provider Information

NPI Number	:	1669805024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI MARIE WEEBER RD, LD

Provider Business Mailing Address
First Line	:	3724 JEFFERSON ST STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-6204
Country	:	US
Telephone Number	:	512-693-7045
Fax Number	:

Provider Business Practice Location Address
First Line	:	1858 E TURKEYFOOT LAKE RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-5428
Country	:	US
Telephone Number	:	563-599-3233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2013
Last Update Date	:	12/11/2025

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