Active NPI
Patrick D Weaver, PT
- Physical Therapist
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2627 Riverside Ave
Suite 300
Jacksonville, FL 32204-4712 - Phone
- (904) 634-0640
- Fax
- (904) 634-0203
- NPI assigned
- Aug 29, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
2627 Riverside Ave
Suite 300
Jacksonville, FL 32204-4712
Mailing address
6500 Bowden Rd
Suite 103
Jacksonville, FL 32216-8070
Phone (904) 634-0640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT22466 | Other | FL | LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2627 Riverside Ave
FL 3
Jacksonville, FL 32204-4717
Phone (904) 634-0640
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.75 of 100
- Quality
- 88.19
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients | |
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients |
Locations
6500 Bowden Rd
Ste 103
Jacksonville, FL 32216
2627 Riverside Ave
Fl 3
Jacksonville, FL 32204
Phone 9046340640 ext. 1014
2627 Riverside Ave
Ste 300
Jacksonville, FL 32204
Phone (904) 634-0460
10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-7546
Interoperability endpoints
- patrick.weaver.1@22724.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Jacksonville, FL
- NPI 1629025820
-
- Durable Medical Equipment & Medical Supplies
- St Johns, FL
- NPI 1538952379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1124137625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 BOWDEN RD",
"address_2": "SUITE 103",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168070",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2627 RIVERSIDE AVE",
"address_2": "SUITE 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322044712",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "PATRICK",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "PT22466",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.