Individual provider Active NPI

Arlondra Weaver, PA

  • Medical Physician Assistant
  • Columbia, SC
National Provider Identifier
1215039649
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1002 Issued in SC
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

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418002225 SC Practitioner - Physician Assistant 6507818390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1002SCMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive MD SC,P.a. PastSince Nov 19, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.