Active NPI
Chad W Weare, MD
- Anesthesiology Physician
- Evansville, IN
National Provider Identifier
1316985468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01057466A
- Practice address
- 3700 Washington Ave
St Mary's Medical Center Anesthesia Dept
Evansville, IN 47750 - Phone
- (812) 485-4000
- NPI assigned
- Jun 2, 2006
- Last updated
- May 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01057466A | IN | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 01057466A | IN |
Addresses
Primary practice location
3700 Washington Ave
St Mary's Medical Center Anesthesia Dept
Evansville, IN 47750
Mailing address
PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000289680 | Other | IN | BLUE SHIELD |
| P00107706 | Other | RAILROAD MEDICARE | |
| 200452210 | Medicaid | IN | |
| 64072325 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01057466A | IN | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306368000000",
"number": "1316985468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3276",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477313276",
"telephone_number": "812-473-0181",
"fax_number": "812-473-5822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"address_2": "ST MARY'S MEDICAL CENTER ANESTHESIA DEPT",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "47750",
"telephone_number": "812-485-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEARE",
"first_name": "CHAD",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2011-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01057466A",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "IN",
"license": "01057466A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000000289680",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00107706",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200452210",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64072325",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.