Jere H Weaver, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

11631 Issued in AL

Practice address

722 Bank St NE
Decatur, AL 35601-1610

Phone

(256) 351-1874

Fax

(256) 351-1876

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AL

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

Practice roles

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.

• Aqua Dermatology of Alabama PC

  • MOHS-Micrographic Surgery Physician
  • Vestavia HLS, AL
  • NPI 1477708642

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1265436067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 BANK ST NE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356011610",
            "telephone_number": "256-351-1874",
            "fax_number": "256-351-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 BANK ST NE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356011610",
            "telephone_number": "256-351-1874",
            "fax_number": "256-351-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JERE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "11631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "51025264",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009912888",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4585899",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "01-12771",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD RETIREE",
            "identifier": "010050478",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-97711",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wayne E. Thomas, MD
• William Weatherbee
• Diane Weatherford
• Malcolm Weathers, MD
• Angel Weaver
• Sydney Elise Weed, RBT
• Aurelia R Weems, DPT
• Julianna Weikert, DNP, CRNA
• Timothy Patrick Weirich, MD
• Leigh Ann Welborn, SLP

• Dermatology Physician in Decatur, AL
• Providers in Decatur, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.