Active NPI
Kelley Jo Anna Weaver
- Clinical Nurse Specialist
- Monroe, NC
National Provider Identifier
1376411751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 433
- Practice address
- 2900 Faircroft Way
Monroe, NC 28110-8838 - Phone
- (704) 421-2894
- NPI assigned
- Oct 27, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 433 | NC | Primary |
Addresses
Primary practice location
2900 Faircroft Way
Monroe, NC 28110-8838
Mailing address
2900 Faircroft Way
Monroe, NC 28110-8838
Phone (704) 421-2894
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 433 | NC | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761523200000",
"number": "1376411751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 FAIRCROFT WAY",
"city": "MONROE",
"state": "NC",
"postal_code": "281108838",
"telephone_number": "704-421-2894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 FAIRCROFT WAY",
"city": "MONROE",
"state": "NC",
"postal_code": "281108838",
"telephone_number": "704-421-2894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "KELLEY JO",
"middle_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-27",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "NC",
"license": "433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.