Craig C Weaver, MD
Individual provider Active NPI Family Medicine Physician · Jacksonville, TX
NPI 1225004906 · NPPES record last updated Oct 14, 2014
Key facts
- NPI
- 1225004906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- H4782 (TX)
- Practice address
- 2026 S Jackson
Jacksonville, TX 75766 - Phone
- (903) 586-5678
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Texas Medical Branch at Galveston, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ault McInnis PLLC
Practice addresses (Care Compare)
2114 E Rusk St
Jacksonville, TX 75766-9052
Phone (903) 284-6105
Hospital & facility affiliations
- Christus Mother Frances Hospital- Jacksonville
- Ut Health East Texas Jacksonville Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040421001634 | TX | Practitioner - Family Practice | 9931195336 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H4782 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mother Frances Hospital Jacksonville | Current |
Accepting new patients | |
| Ault McInnis PLLC | Family Medicine | Current |
Accepting new patients |
| Christus Trinity Clinic Texas | Family Medicine | Current | Accepting new patients |
Locations
2116 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
2114 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105
800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018
3802 Manhatton Dr
Tyler, TX 75701
Phone (903) 509-8888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H4782 | TX | Yes |
Addresses
Primary practice location
2026 S Jackson
Jacksonville, TX 75766
Mailing address
PO Box 847522
Dallas, TX 75284-7522
Phone (903) 531-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8A9565 | Other | TX | BCBS |
| 137834112 | Medicaid | TX |
Other providers in Jacksonville, TX
- Walgreen Co
- Walgreen Co
- Amanda Michelle Walsh
- Andre Joseph Ward
- Austin A Weaver
- Kent P Webb
- Susan Carol West Jan
- Bradley Kent Westbrook
- Kierra Nicole Whitaker
- Kristin White
All providers in Jacksonville, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.