Michael James Weaver, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5003 Issued in RI

Practice address

553 Kingstown Rd
Wakefield, RI 02879-3600

Phone

(401) 304-9111

Fax

(401) 284-0625

NPI assigned

May 2, 2006

Last updated

Aug 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Victa LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Providence, RI
  • NPI 1104317007
  Medicare reassignment NPD
• Family Doctor Plus Ri LLC

  • Primary Care Clinic/Center
  • Wakefield, RI
  • NPI 1386041507
  Authorized official Same address or phone

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1215995097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 KINGSTOWN RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793600",
            "telephone_number": "401-304-9111",
            "fax_number": "401-284-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 KINGSTOWN RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793600",
            "telephone_number": "401-304-9111",
            "fax_number": "401-284-0625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Wells St",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028912924",
            "country_code": "US",
            "telephone_number": "401-596-0174",
            "fax_number": "401-596-2266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "05003",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "5003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MW01082",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Wardle, RN
• Pamela Gail Watson, LICSW
• Sara E Watson, M.D.
• Nicole Watts
• Aaron W Way, D.O.
• Cynthia E Weber, PTA
• Mary D Wedlock, BA
• Aaron Weisbord, M.D.
• Jessica Wells, DO, MPH
• Barry M Wepman, M.D.

• Family Medicine Physician in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Family Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.

Verify at the official NPI Registry.