Active NPI
Donald D. Weaver, M.D.
- Geriatric Medicine (Family Medicine) Physician
- Gulfport, MS
National Provider Identifier
1255447900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 14403
- Practice address
- 1612 31St Ave
Gulfport, MS 39501-2750 - Phone
- (228) 864-8454
- Fax
- (228) 865-1457
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 14403 | MS | Primary |
Addresses
Primary practice location
1612 31St Ave
Gulfport, MS 39501-2750
Mailing address
30 S. Clinton St.
Suite 7205
Walla Walla, WA 99362-2497
Phone (509) 522-1358
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110136321 | Other | MS | RAILROAD MEDICARE |
| 00114891 | Medicaid | MS |
Other names 1
- Dr. Donald Weaver
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1255447900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 S. CLINTON ST.",
"address_2": "SUITE 7205",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622497",
"telephone_number": "509-522-1358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1612 31ST AVE",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395012750",
"telephone_number": "228-864-8454",
"fax_number": "228-865-1457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "DONALD",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "MS",
"license": "14403",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110136321",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00114891",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DONALD",
"last_name": "WEAVER",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.