Active NPI
Paula J Weaver
- Speech-Language Pathologist
- Enid, OK
National Provider Identifier
1114194362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2571
- Practice address
- 2615 E Randolph Ave
Enid, OK 73701-4670 - Phone
- (580) 234-3734
- Fax
- (580) 234-3554
- NPI assigned
- May 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2571 | OK | Primary |
Addresses
Primary practice location
2615 E Randolph Ave
Enid, OK 73701-4670
Mailing address
2615 E Randolph Ave
Enid, OK 73701-4670
Phone (580) 234-3734
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100653300B | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2571 | OK | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1114194362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 E RANDOLPH AVE",
"city": "ENID",
"state": "OK",
"postal_code": "737014670",
"telephone_number": "580-234-3734",
"fax_number": "580-234-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 E RANDOLPH AVE",
"city": "ENID",
"state": "OK",
"postal_code": "737014670",
"telephone_number": "580-234-3734",
"fax_number": "580-234-3554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "PAULA",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2571",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100653300B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.