Active NPI
Carrol R Weaver, PH.D.
- Psychologist
- Oklahoma City, OK
National Provider Identifier
1275569022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 541
- Practice address
- 6307 Waterford Blvd
Suite 145
Oklahoma City, OK 73118-1125 - Phone
- (405) 848-1191
- Fax
- (405) 848-1224
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 541 | OK | Primary |
Addresses
Primary practice location
6307 Waterford Blvd
Suite 145
Oklahoma City, OK 73118-1125
Mailing address
6307 Waterford Blvd
Suite 145
Oklahoma City, OK 73118-1125
Phone (405) 848-1191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 541 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275569022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6307 WATERFORD BLVD",
"address_2": "SUITE 145",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731181125",
"telephone_number": "405-848-1191",
"fax_number": "405-848-1224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6307 WATERFORD BLVD",
"address_2": "SUITE 145",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731181125",
"telephone_number": "405-848-1191",
"fax_number": "405-848-1224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "CARROL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OK",
"license": "541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.