Keith Andrew Weaver, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2076 Issued in TN

Practice address

1013 Executive Dr
Suite 101
Hixson, TN 37343-7912

Phone

(423) 875-2538

Fax

(423) 875-2539

NPI assigned

Apr 30, 2007

Last updated

Feb 7, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

General Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Compassionate Health Care LLCGroup PAC ID 2264564566, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keith.weaver.1@32871.direct.athenahealth.com

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.

• Compassionate Health Care LLC

  • Internal Medicine Physician
  • Hixson, TN
  • NPI 1790009793
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health Care System Inc.

  dba Memorial Hospital Hixson

  • General Acute Care Hospital
  • Hixson, TN
  • NPI 1083778633
  Care Compare affiliation
• Memorial Health Care System Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736
  Care Compare affiliation

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1265652317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 EXECUTIVE DR",
            "address_2": "SUITE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437912",
            "telephone_number": "423-875-2538",
            "fax_number": "423-875-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 EXECUTIVE DR",
            "address_2": "SUITE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437912",
            "telephone_number": "423-875-2538",
            "fax_number": "423-875-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "2076",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "2076",
            "primary": true
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "VA",
            "license": "0102201853",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519501",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Troy Therle Wall, RPH
• Martin Lee Waller II, LDO
• Rui Wang, MD
• Heather Shay Ward, FNP
• Michael Jerry Ward, D.D.S.
• Donna Faye Webb, DPH
• Elizabeth Flanagan Webb, D.D.S
• Jeffrey Christopher Weir, PT, DPT
• Regina K Welborn, CRNA
• Well Adjusted Chiropractic

• General Practice Physician in Hixson, TN
• Providers in Hixson, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.