Individual provider Active NPI

Wendi Weaver, DDS

  • Dentist
  • Waco, TX
National Provider Identifier
1114101821
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18876 Issued in TX
Practice address
1800 Gurley Lane
Waco, TX 76706
Phone
(254) 313-6000
Fax
(254) 313-4531
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18876 TX Primary

Addresses

Primary practice location

1800 Gurley Lane
Waco, TX 76706

Mailing address

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181008000764 TX Practitioner - Dentist 7012207426 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18876TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Community Health Center, Inc CurrentSince Jun 12, 2018 Accepting new patients
Heart of Texas Community Health Center, Inc. CurrentSince Jun 12, 2018 Accepting new patients
Heart of Texas Community Health Center Inc Current Accepting new patients

Locations

1600 Providence Dr
Waco, TX 76707
Phone (254) 313-4200

1800 Gurley Ln
Waco, TX 76706
Phone (254) 313-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1114101821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GURLEY LANE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76706",
            "telephone_number": "254-313-6000",
            "fax_number": "254-313-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "WENDI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.