Jeffrey Lee Weaver, PA-C, MMS

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C03641 Issued in MD

Practice address

725 W Lombard St
Suite 163 B
Baltimore, MD 21201-1009

Phone

(410) 706-2125

Fax

(410) 706-3243

NPI assigned

Jun 9, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1306005897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-706-2125",
            "fax_number": "410-706-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W LOMBARD ST",
            "address_2": "SUITE 163 B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011009",
            "telephone_number": "410-706-2125",
            "fax_number": "410-706-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C, MMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C03641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caia Weaver
• Debbie Weaver, M.D.
• Deidre Weaver, CRNA
• Douglas Thornton Weaver, D.C.
• Jahmya Weaver
• Jesse Robert Weaver, DDS
• Karin D. Weaver, PA-C
• Kristen Ronn Weaver, N.P.
• Lauren Alexandra Weaver, MD
• Mary Catherine Weaver, LGPC

• Medical Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.