Susan Weaver

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2013002280 Issued in MO

Practice address

1723 Broadway St Ste 410
Cape Girardeau, MO 63701-4556

Phone

(573) 332-7746

Fax

(573) 339-9709

NPI assigned

Feb 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pappas Chiropractic Health Center, P.C.

  • General Practice Physician
  • Jackson, MO
  • NPI 1336253574

  Nurse Practitioner

  Medicare reassignment NPD
• Southeastern Emergency Services of Memphis, P.C.

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1164454450

  MO, Nurse Practitioner

  Medicare reassignment NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295074094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 410",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-332-7746",
            "fax_number": "573-339-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 410",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-332-7746",
            "fax_number": "573-339-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2013002280",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013002280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Elijah Warren, DC
• Danielle Nichole Wash, LPC, NCC
• Cheryl Wasilewski, P.T.
• Susan Watkins
• Jered Michael Wayland, D.C.
• Delandric Webb
• Nancy E Weber-Bornstein, M.D.
• Zachary Michael Weber, ATC
• Patricia Wehmeyer, PHARMD
• Kylee Beth Weidenbenner, MA, SLP

• Family Nurse Practitioner in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.