Active NPI
Travis Weaver, D.O.
- Endocrinology, Diabetes & Metabolism Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 02007513A
- Practice address
- 1815 E Ireland Rd
South Bend, IN 46614-2845 - Phone
- (574) 647-1700
- Fax
- (574) 647-7572
- NPI assigned
- Apr 9, 2015
- 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 |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 02007513A | IN | Primary |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 0102204753 | VA |
Addresses
Primary practice location
1815 E Ireland Rd
South Bend, IN 46614-2845
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725
Other practice location 1
6901 N Main St Ste 102
Granger, IN 46530-8022
Phone (574) 647-5245
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300083607 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1815 E Ireland Rd
Beacon Medical Group Ireland Rd
South Bend, IN 46614-2845
Phone (574) 647-1700
Hospital & facility affiliations
- Memorial Hospital of South Bend
- Elkhart General Hospital
- Community Hospital of Bremen Inc
- Saint Joseph Regional Medical Center - Plymouth
- Franciscan Health Michigan City
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
6901 N Main St
Ste 102
Granger, IN 46530
Phone (574) 647-4500
900 I St
Laporte, IN 46350
Phone (219) 324-1670
1815 E Ireland Rd
South Bend, IN 46614
Phone (574) 647-1700
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.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Family Medicine Physician
- South Bend, IN
- NPI 1124079330
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Bremen, IN
- NPI 1568417004
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
- General Acute Care Hospital
- La Porte, IN
- NPI 1679336747
-
- General Acute Care Hospital
- Michigan City, IN
- NPI 1710051941
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
-
- General Acute Care Hospital
- Plymouth, IN
- NPI 1174571129
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784851200000",
"number": "1063808772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 HEALTH DR STE 100",
"city": "GRANGER",
"state": "IN",
"postal_code": "465301380",
"telephone_number": "574-647-3725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 E IRELAND RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142845",
"telephone_number": "574-647-1700",
"fax_number": "574-647-7572"
}
],
"practiceLocations": [
{
"address_1": "6901 N Main St Ste 102",
"address_purpose": "LOCATION",
"city": "Granger",
"state": "IN",
"postal_code": "465308022",
"country_code": "US",
"telephone_number": "574-647-5245",
"fax_number": "574-647-7572",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEAVER",
"first_name": "TRAVIS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-09",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "IN",
"license": "02007513A",
"primary": true
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "VA",
"license": "0102204753",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300083607",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.