Active NPI
Kristen Frances Weaver, PTA
- Physical Therapy Assistant
- Fairmont, WV
National Provider Identifier
1164709762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1433
- Practice address
- 130 Kaufman Dr
Fairmont, WV 26554-2179 - Phone
- (304) 363-4891
- NPI assigned
- Nov 10, 2011
- Last updated
- Nov 10, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1433 | WV | Primary |
Addresses
Primary practice location
130 Kaufman Dr
Fairmont, WV 26554-2179
Mailing address
RR 3 Box 377
Grafton, WV 26354-9566
Phone (304) 612-4825
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 |
|---|---|---|---|
| 1433 | WV | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320883200000",
"number": "1164709762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 3 BOX 377",
"city": "GRAFTON",
"state": "WV",
"postal_code": "263549566",
"telephone_number": "304-612-4825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 KAUFMAN DR",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542179",
"telephone_number": "304-363-4891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "KRISTEN",
"middle_name": "FRANCES",
"name_prefix": "Miss",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-10",
"last_updated": "2011-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WV",
"license": "1433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairmont, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.