Individual provider Active NPI

Judy E Weaver, APRNBC

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1063481224
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN089815 Issued in GA
Practice address
1007 Greenfield Dr
Tifton, GA 31794-3795
Phone
(229) 382-9733
Fax
(229) 387-6161
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R089815 GA
Family Nurse Practitioner 363LF0000X RN089815 GA Primary

Addresses

Primary practice location

1007 Greenfield Dr
Tifton, GA 31794-3795

Mailing address

907 18TH St E Ste 400
Tifton, GA 31794-3684
Phone (229) 353-3422

Other identifiers 1

IdentifierTypeStateIssuer
00844368AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address judyweaver@trhs.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20051115000900 GA Practitioner - Nurse Practitioner 1557380987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

1007 Greenfield Dr
Tifton, GA 31794-3795
Phone (229) 382-9733

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.02 of 100Reported as group
Quality
57.87
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R089815GAMDAcute Care Nurse Practitioner
RN089815GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Aug 1, 2019 Accepting new patients
Tift Regional Health System Inc CurrentSince Oct 6, 2014 Accepting new patients
Tift Regional Health System Inc CurrentSince Aug 1, 2019 Accepting new patients
Tift Regional Health System Inc CurrentSince Oct 6, 2014 Accepting new patients

Locations

260 Mj Taylor Rd
Adel, GA 31620
Phone (229) 247-2290

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

907 18th St E
Ste 400
Tifton, GA 31794

907 18th St E
Ste 150
Tifton, GA 31794
Phone (229) 353-3422

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

1007 Greenfield Dr
Tifton, GA 31794
Phone (229) 382-9733

Interoperability endpoints

  • Direct secure messaging: judyweaver@trhs.cernerdirect.com

Organizations & group practices 4

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1063481224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 400",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943684",
            "telephone_number": "229-353-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 GREENFIELD DR",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943795",
            "telephone_number": "229-382-9733",
            "fax_number": "229-387-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JUDY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "APRNBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "R089815",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN089815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00844368A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "judyweaver@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1007 Greenfield Dr",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317943795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.