Individual provider Active NPI

David L Weaver Jr., MD

  • Obstetrics & Gynecology Physician
  • Enid, OK
National Provider Identifier
1356340327
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
23176 Issued in OK
Practice address
601 W Garriott Rd
Enid, OK 73701-5524
Phone
(580) 977-1903
Fax
(580) 548-1434
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 23176 OK Primary

Addresses

Primary practice location

601 W Garriott Rd
Enid, OK 73701-5524

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (580) 977-1903

Other identifiers 1

IdentifierTypeStateIssuer
100845660AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040225000350 OK Practitioner - Obstetrics/Gynecology 3274429493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23176OKMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Obstetrics & Gynecology CurrentSince Oct 1, 2013 Accepting new patients
Integris Bass Baptist Health Center Past Accepting new patients

Locations

601 W Owen K Garriott Rd
Enid, OK 73701
Phone (580) 233-1100

620 S Madison St
Ste 301
Enid, OK 73701
Phone (580) 233-6350

620 S Madison St
Ste 209
North Enid, OK 73701
Phone (580) 233-5553

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1356340327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "580-977-1903",
            "fax_number": "580-548-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W GARRIOTT RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015524",
            "telephone_number": "580-977-1903",
            "fax_number": "580-548-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "23176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100845660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.