Kelly M Weaver, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5796 Issued in OH

Practice address

3011 Bethel Rd Ste 100
Columbus, OH 43220-6104

Phone

(614) 459-2156

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Kelly M. Weaver, PH.D., Inc.

  • Psychologist
  • Columbus, OH
  • NPI 1770678146
  NPD (past) Authorized official

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1275575334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 BETHEL RD STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432206104",
            "telephone_number": "614-459-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 BETHEL RD STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432206104",
            "telephone_number": "614-459-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lee Weaver, O.D.
• Jessica Nicole Weaver, SWT
• Joel M Weaver, DDS PHD
• Joseph Thomas Weaver, DO
• Katelyn Weaver, LSW
• Lauren J Weaver, MS, CCC-SLP
• Madison Rae Weaver
• Meagan Weaver, CNP
• Michelle Weaver, MS, CNP
• Patrice Weaver

• Clinical Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.