NPIMap

Individual provider Active NPI

Brian Shanklin Weaver, MD

  • Interventional Pain Medicine Physician
  • Norfolk, VA
National Provider Identifier
1104988328
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
0101245237 Issued in VA
Practice address
814 Kempsville Rd
Suite 104
Norfolk, VA 23502-4001
Phone
(757) 455-8887
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MT186418 PA
Pain Medicine (Anesthesiology) Physician 207LP2900X 0101245237 VA
Interventional Pain Medicine Physician 208VP0014X 0101245237 VA Primary
Pain Medicine Physician 208VP0000X 0101245237 VA

Addresses

Primary practice location

814 Kempsville Rd
Suite 104
Norfolk, VA 23502-4001

Mailing address

927 East Blvd
Charlotte, NC 28203-5203
Phone (704) 377-5772

Other identifiers 2

IdentifierTypeStateIssuer
P00918125OtherVARAILROAD MEDICARE
5911825MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090616000464 NC Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 9931259744 Reassigns benefits to 1 organization
I20090724000056 VA Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 9931259744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
Eastern Virginia Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Pain and Spine Care Specialists, LLCGroup PAC ID 9133657653, 2 clinicians

Practice addresses (Care Compare)

814 Kempsville Rd
Suite 104
Norfolk, VA 23502-4001
Phone (757) 455-8887

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.55 of 100Reported as individual
Quality
79.68
Improvement activities
40
Cost
75.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT186418PAMDAnesthesiology Physician
0101245237VAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Pain & Spine Care Specialists, LLC Interventional Pain Medicine CurrentSince Dec 24, 2024 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Current Accepting new patients
Southeast Anesthesiology Consultants of Virginia, PLLC Anesthesiology CurrentSince Feb 21, 2011 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Sep 1, 2011 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Past Accepting new patients
Southeast Pain Management Services, PLLC Pain Medicine Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

814 Kempsville Rd
Ste 104
Norfolk, VA 23502
Phone (757) 455-8887

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDEHDD/Endpoint/CDEHDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CDEHDD

Organizations & group practices 6

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 6

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1104988328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035203",
            "telephone_number": "704-377-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 KEMPSVILLE RD",
            "address_2": "SUITE 104",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024001",
            "telephone_number": "757-455-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "BRIAN",
        "middle_name": "SHANKLIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT186418",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101245237",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "VA",
            "license": "0101245237",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "VA",
            "license": "0101245237",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00918125",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911825",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.