Active NPI
Edward Weaver Jr., O.D.
- Optometrist
- Wilmington, NC
National Provider Identifier
1346245263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1234
- Practice address
- 1205 Floral Pkwy
Wilmington, NC 28403-6216 - Phone
- (910) 791-6086
- Fax
- (910) 392-8087
- NPI assigned
- Jun 16, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1234 | NC | Primary |
Addresses
Primary practice location
1205 Floral Pkwy
Wilmington, NC 28403-6216
Mailing address
1205 Floral Pkwy
Wilmington, NC 28403-6216
Phone (910) 791-6086
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7909965 | Medicaid | NC | |
| 0250H | Other | NC | BCBS PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1234 | NC | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1346245263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 FLORAL PKWY",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036216",
"telephone_number": "910-791-6086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 FLORAL PKWY",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036216",
"telephone_number": "910-791-6086",
"fax_number": "910-392-8087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "EDWARD",
"name_suffix": "Jr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1234",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7909965",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "0250H",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.