NPIMap

Organization Active NPI

Doctors Weaver & Weaver P C

  • Neurological Surgery Physician
  • Roanoke, VA
National Provider Identifier
1154419802
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
0101033189 Issued in VA
Legal business name
DOCTORS WEAVER & WEAVER P C
Practice address
5304 Indian Grave Rd SW
Suite a
Roanoke, VA 24018-9108
Phone
(540) 772-7107
Fax
(540) 772-7858
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Mrs. Donna C Sebestin
Title
Manager
Phone
(540) 772-7107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 0101033189 VA Primary

Addresses

Primary practice location

5304 Indian Grave Rd SW
Suite a
Roanoke, VA 24018-9108

Mailing address

5304 Indian Grave Rd SW
Suite a
Roanoke, VA 24018-9108
Phone (540) 772-7107

Other identifiers 3

IdentifierTypeStateIssuer
006196705MedicaidVA
C12923OtherRAILROAD MEDICARE LEGACY
006104321MedicaidVA

National Provider Directory

National Provider Directory

Locations

5304 Indian Grave Rd
Ste A
Roanoke, VA 24018
Phone (540) 772-7107

1315 2nd St SW
Ste 102
Roanoke, VA 24016
Phone (540) 206-3677

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1154419802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 INDIAN GRAVE RD SW",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240189108",
            "telephone_number": "540-772-7107",
            "fax_number": "540-772-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 INDIAN GRAVE RD SW",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240189108",
            "telephone_number": "540-772-7107",
            "fax_number": "540-772-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS WEAVER & WEAVER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "SEBESTIN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "540-772-7107",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101033189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006196705",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE LEGACY",
            "identifier": "C12923",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006104321",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.

Verify at the official NPI Registry.