Active NPI
Everette Arden Weathers, MD
- Surgery Physician
- Orangeburg, SC
National Provider Identifier
1033195490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5244
- Practice address
- 1175 Cook Rd
Suite 320
Orangeburg, SC 29118-8201 - Phone
- (803) 536-2555
- Fax
- (803) 536-0998
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5244 | SC | Primary |
| Internal Medicine Physician | 207R00000X | 5244 | SC |
Addresses
Primary practice location
1175 Cook Rd
Suite 320
Orangeburg, SC 29118-8201
Mailing address
PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 536-2555
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 576008010-012 | Other | SC | BCBS |
| 32409 | Other | SC | MEDCOST |
| 9204593 | Other | SC | CIGNA |
| 622230 | Other | SC | FIRST CHOICE |
| 052445 | Medicaid | SC | |
| 9645030 | Other | SC | GHI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- https://api.platform.athenahealth.com/14374/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462233600000",
"number": "1033195490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1245",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291161245",
"telephone_number": "803-536-2555",
"fax_number": "803-536-0998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 COOK RD",
"address_2": "SUITE 320",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291188201",
"telephone_number": "803-536-2555",
"fax_number": "803-536-0998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERS",
"first_name": "EVERETTE",
"middle_name": "ARDEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2016-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "5244",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "5244",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "576008010-012",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "32409",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9204593",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CHOICE",
"identifier": "622230",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "052445",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "9645030",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orangeburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.