Individual provider Active NPI

Amber Nicole Weakley

  • Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1063245967
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024191079 Issued in VA
Practice address
1200 E Marshall St
Richmond, VA 23298-5023
Phone
(804) 828-9205
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001245261 VA
Nurse Practitioner 363L00000X 0024191079 VA Primary

Addresses

Primary practice location

1200 E Marshall St
Richmond, VA 23298-5023

Mailing address

7125 Brandy Run Dr Apt 103
Mechanicsville, VA 23111-3675
Phone (804) 317-9480

Other practice location 1

1250 E Marshall St
Richmond, VA 23298-5023
Phone (804) 628-4327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241218004371 VA Practitioner - Nurse Practitioner 6002343795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Virginia Commonwealth University, School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1200 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001245261VAMDRegistered Nurse
0024191079VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Nov 10, 2024 Accepting new patients

Locations

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1200 E Marshall St
Richmond, VA 23298
Phone (804) 827-0561

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1063245967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 BRANDY RUN DR APT 103",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113675",
            "telephone_number": "804-317-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985023",
            "telephone_number": "804-828-9205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985023",
            "country_code": "US",
            "telephone_number": "804-628-4327",
            "fax_number": "804-828-8199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAKLEY",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001245261",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024191079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.