Individual provider Active NPI

Victoria Faye Weaver, PA-C

  • Physician Assistant
  • Dover, OH
National Provider Identifier
1104402106
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1104402106 Issued in OH
Practice address
603 Monroe St
Dover, OH 44622-2046
Phone
(330) 364-8889
Fax
(330) 343-7505
NPI assigned
Mar 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1104402106 OH Primary

Addresses

Primary practice location

603 Monroe St
Dover, OH 44622-2046

Mailing address

PO Box 80690
Canton, OH 44708-0690
Phone (330) 363-7444

Other names 1

  • Tori Weaver Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211021002648 OH Practitioner - Physician Assistant 2567850654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orrville Hospital FoundationGroup PAC ID 7911890546, 78 clinicians

Practice addresses (Care Compare)

603 Monroe St
Dover, OH 44622-2046
Phone (330) 364-8889

Hospital & facility affiliations

  • Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323
  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Union Hospital Hospital, Dover, OH, CCN 360010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1104402106OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orrville Hospital Foundation CurrentSince Nov 8, 2021 Accepting new patients
Orrville Hospital Foundation CurrentSince Nov 8, 2021 Accepting new patients
Orrville Hospital Foundation Past Accepting new patients
Orrville Hospital Foundation Past Accepting new patients

Locations

603 Monroe St
Dover, OH 44622
Phone (330) 364-8889

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

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 3

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": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1104402106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447080690",
            "telephone_number": "330-363-7444",
            "fax_number": "330-363-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MONROE ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222046",
            "telephone_number": "330-364-8889",
            "fax_number": "330-343-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "VICTORIA",
        "middle_name": "FAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-20",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "1104402106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TORI",
            "last_name": "WEAVER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.