Jack T Weaver DPM DO MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS0004936 Issued in FL

Legal business name

JACK T WEAVER DPM DO MD PA

Practice address

3120 Corrine Dr
Orlando, FL 32803-2206

Phone

(407) 894-1931

Fax

(407) 894-5919

NPI assigned

Nov 13, 2006

Last updated

Dec 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Howard D Weaver, DONPI 1710962857

Title

Physician

Phone

(407) 894-1931

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Howard Daniel Weaver, D.O.

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1710962857
  Medicare reassignment Care Compare group NPD Authorized official
• Debra S Albers, DO

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1245215730
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1063583904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 CORRINE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032206",
            "telephone_number": "407-894-1931",
            "fax_number": "407-894-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 CORRINE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032206",
            "telephone_number": "407-894-1931",
            "fax_number": "407-894-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK T WEAVER DPM DO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-894-1931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0004936",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0005348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Tawa Jablonski, M.D.
• Donald V Jablonski, M.D.
• Janet Jablonski, M.D.
• Carlos M Jacinto, MD
• Jack Faup MD PA
• Debra C Jack, RN
• Joricely Jack
• Erin Nicole Jacks, PHARMD
• Jackson Therapy Partners
• Akenia Jackson, LPN

• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.