Individual provider Active NPI

Seth A Weaver, DPM

  • Foot & Ankle Surgery Podiatrist
  • Hickory, NC
National Provider Identifier
1215914031
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
458 Issued in NC
Practice address
1501 Tate Blvd SE
Suite 203
Hickory, NC 28602-4243
Phone
(828) 304-0400
Fax
(828) 304-0142
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 458 NC Primary

Addresses

Primary practice location

1501 Tate Blvd SE
Suite 203
Hickory, NC 28602-4243

Mailing address

1501 Tate Blvd SE
Suite 203
Hickory, NC 28602-4243
Phone (828) 304-0400

Other identifiers 1

IdentifierTypeStateIssuer
890808KMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170602000981 DC Practitioner - Podiatry 1951372812 Reassigns benefits to 1 organization
I20170602001223 MD Practitioner - Podiatry 1951372812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
458NCMDAddiction (Substance Use Disorder) Counselor
01620MDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Maryland Foot and Ankle LLC Foot & Ankle Surgery CurrentSince May 8, 2017 Accepting new patients
Merritt Island Foot & Ankle Inc Foot & Ankle Surgery PastSince Sep 8, 1999 Accepting new patients

Locations

12070 Old Line Ctr
Ste 110
Waldorf, MD 20602
Phone (301) 638-0021

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1215914031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE",
            "address_2": "SUITE 203",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024243",
            "telephone_number": "828-304-0400",
            "fax_number": "828-304-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE",
            "address_2": "SUITE 203",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024243",
            "telephone_number": "828-304-0400",
            "fax_number": "828-304-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "SETH",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890808K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.