Organization Active NPI

Elizabeth M Weaver, M.D., P.L.C.

  • Family Medicine Physician
  • Herndon, VA
National Provider Identifier
1336511971
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101232754 Issued in VA
Legal business name
ELIZABETH M WEAVER, M.D., P.L.C.
Practice address
1031 Sterling Rd
Suite 203
Herndon, VA 20170-3865
Phone
(703) 466-5150
Fax
(703) 649-3557
NPI assigned
Oct 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Authorized official

Name
Mrs. Elizabeth Mary Weaver, M.D.NPI 1689744252
Title
Owner
Phone
(703) 466-5150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0101232754 VA Primary

Addresses

Primary practice location

1031 Sterling Rd
Suite 203
Herndon, VA 20170-3865

Mailing address

1031 Sterling Rd
Suite 203
Herndon, VA 20170-3865
Phone (703) 466-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151105001109 DC Part B Supplier - Clinic/Group Practice 9133439060 Receives reassigned benefits from 2 practitioners
Practice locations: Herndon, VA

National Provider Directory

National Provider Directory

Locations

209 Elden St
Ste 209
Herndon, VA 20170
Phone (703) 435-2574

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1336511971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 STERLING RD",
            "address_2": "SUITE 203",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201703865",
            "telephone_number": "703-466-5150",
            "fax_number": "703-649-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 STERLING RD",
            "address_2": "SUITE 203",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201703865",
            "telephone_number": "703-466-5150",
            "fax_number": "703-649-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH M WEAVER, M.D., P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-466-5150",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101232754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.