Active NPI
Arlondra Weaver, PA
- Medical Physician Assistant
- Columbia, SC
National Provider Identifier
1215039649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1002
- Practice address
- 1715 Blanding St
Columbia, SC 29201-3441 - Phone
- (803) 999-5920
- Fax
- (803) 999-5930
- NPI assigned
- Sep 5, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 104092 | NC | |
| Medical Physician Assistant | 363AM0700X | 1002 | SC | Primary |
Addresses
Primary practice location
1715 Blanding St
Columbia, SC 29201-3441
Mailing address
1715 Blanding St
Columbia, SC 29201-3441
Phone (803) 999-5920
Other practice location 1
131 Wildewood Park Dr
Columbia, SC 29223-4300
Phone (803) 999-4030
Other practice location 2
125 Park Place Ct
Lexington, SC 29072-6690
Phone (803) 999-3380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250418002225 | SC | Practitioner - Physician Assistant | 6507818390 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002 | SC | MD | Cognitive & Behavioral Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proactive MD SC,P.a. | Past | Accepting new patients |
Interoperability endpoints
- arlondra.weaver.1@23284.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Lexington, SC
- NPI 1629842240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1215039649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 BLANDING ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292013441",
"telephone_number": "803-999-5920",
"fax_number": "803-999-5930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 BLANDING ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292013441",
"telephone_number": "803-999-5920",
"fax_number": "803-999-5930"
}
],
"practiceLocations": [
{
"address_1": "131 Wildewood Park Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292234300",
"country_code": "US",
"telephone_number": "803-999-4030",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "125 Park Place Ct",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "SC",
"postal_code": "290726690",
"country_code": "US",
"telephone_number": "803-999-3380",
"fax_number": "803-999-3390",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEAVER",
"first_name": "ARLONDRA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "104092",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "SC",
"license": "1002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.