Roberta Christine Weaver, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP119780 Issued in TX

Practice address

1318 Broadway
Lubbock, TX 79401-3206

Phone

(806) 765-2611

Fax

(806) 765-6271

NPI assigned

Jan 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Roberta Christine Russell Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Texas Tech University Health Science Center School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Developmental Pediatrics, PLLCGroup PAC ID 7517457146, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roberta.weaver@direct.myteamcare.com

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.

• Legacy Developmental Pediatrics, PLLC

  dba Legacy Developmental Pediatrics

  • Nurse Practitioner
  • Lubbock, TX
  • NPI 1295596096
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1356646087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY STE 5",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794013209",
            "telephone_number": "806-765-2611",
            "fax_number": "806-687-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 BROADWAY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794013206",
            "telephone_number": "806-765-2611",
            "fax_number": "806-765-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "ROBERTA",
        "middle_name": "CHRISTINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-11",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "TX",
            "license": "648686",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP119780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERTA",
            "last_name": "RUSSELL",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madison Weatherly
• Ashleigh Weaver
• Cori Weaver, MS, CCC-SLP
• Kallie Weaver, LPC
• Karlye Weaver, OT
• John Bryan Webb, RVT
• Franklin Ernest Weber, DDS
• Deborah Webster Harmon
• Richard L Weddige, MD
• Cody James Weeks, CPHT

• Family Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.