Individual provider Active NPI

Regan Everiss Weaver, AUD

  • Audiologist
  • Austintown, OH
National Provider Identifier
1013561125
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
02205 Issued in OH
Practice address
5533 Mahoning Ave FL 2
Austintown, OH 44515-2366
Phone
(330) 480-3533
Fax
(330) 480-3535
NPI assigned
Jul 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 02205 OH Primary

Addresses

Primary practice location

5533 Mahoning Ave FL 2
Austintown, OH 44515-2366

Mailing address

5533 Mahoning Ave FL 2
Austintown, OH 44515-2366
Phone (330) 480-3533

Other identifiers 1

IdentifierTypeStateIssuer
0363350MedicaidOH

Other names 1

  • Regan Everiss Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823002858 OH Practitioner - Qualified Audiologist 7214265594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02205OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 10, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 27, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Audiologist CurrentSince Jan 10, 2022 Accepting new patients
Cleveland Hearing and Speech Center PastSince Aug 1, 2019 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

5533 Mahoning Ave
Fl 2
Youngstown, OH 44515
Phone (330) 480-3533

Networks

  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO
  • KY PPO C-SNP

Organizations & group practices 5

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 1

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": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1013561125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5533 MAHONING AVE FL 2",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152366",
            "telephone_number": "330-480-3533",
            "fax_number": "330-480-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5533 MAHONING AVE FL 2",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152366",
            "telephone_number": "330-480-3533",
            "fax_number": "330-480-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERISS WEAVER",
        "first_name": "REGAN",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "02205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0363350",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGAN",
            "last_name": "EVERISS",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austintown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.