Active NPI
Brett Weaver, PLADC
- Professional Counselor
- Gordon, NE
National Provider Identifier
1003362146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P-1423
- Practice address
- 305 Foch St
Gordon, NE 69343-1709 - Phone
- (308) 282-1101
- Fax
- (308) 282-1372
- NPI assigned
- Aug 29, 2016
- Last updated
- Aug 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P-1423 | NE | Primary |
Addresses
Primary practice location
305 Foch St
Gordon, NE 69343-1709
Mailing address
305 Foch St
Gordon, NE 69343-1709
Phone (308) 282-1101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470734376-86 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P-1423 | NE | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North East Panhandle Substance Abuse Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Substance Abuse Rehabilitation Facility
- Gordon, NE
- NPI 1558404640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1003362146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 FOCH ST",
"city": "GORDON",
"state": "NE",
"postal_code": "693431709",
"telephone_number": "308-282-1101",
"fax_number": "308-282-1372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 FOCH ST",
"city": "GORDON",
"state": "NE",
"postal_code": "693431709",
"telephone_number": "308-282-1101",
"fax_number": "308-282-1372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "BRETT",
"credential": "PLADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-29",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "P-1423",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470734376-86",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gordon, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.