Individual provider Active NPI

Holly Marie Weaver, A-GNP-C

  • Nurse Practitioner
  • Marshall, MI
National Provider Identifier
1013460567
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704243878 Issued in MI
Practice address
215 E Mansion St Ste 3a
Marshall, MI 49068-1559
Phone
(269) 789-0025
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704243878 MI Primary

Addresses

Primary practice location

215 E Mansion St Ste 3a
Marshall, MI 49068-1559

Mailing address

215 E Mansion St Ste 3a
Marshall, MI 49068-1559
Phone (269) 789-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121000200 MI Practitioner - Nurse Practitioner 2163701806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

215 E Mansion St
Marshall, MI 49068-1559

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Sep 23, 2024 Accepting new patients
Opus Medicine, PC CurrentSince Aug 14, 2017 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Mar 1, 2020 Accepting new patients
Ella E M Brown Charitable Circle Nurse Practitioner CurrentSince Sep 23, 2024 Accepting new patients
Wattles Park Family Practice PC PastSince Jan 1, 2017 Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

3601 S 9th St
Kalamazoo, MI 49009
Phone (269) 372-4700

215 E Mansion St
Ste 3A
Marshall, MI 49068
Phone (269) 781-2658

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

215 E Mansion St
Ste 2A
Marshall, MI 49068
Phone (269) 558-0710

Interoperability endpoints

  • Direct secure messaging: hweaver882733@direct.hfhs.org
  • Direct secure messaging: holly.weaver.1@9698.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1013460567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E MANSION ST STE 3A",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681559",
            "telephone_number": "269-789-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E MANSION ST STE 3A",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681559",
            "telephone_number": "269-789-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704243878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.