Phillips S Weaver, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

155773 Issued in MS

Practice address

716 Watts Avenue
Pascagoula, MS 39567

Phone

(228) 762-5561

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396828505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 654",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "39568",
            "telephone_number": "228-762-5561",
            "fax_number": "228-762-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 WATTS AVENUE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "39567",
            "telephone_number": "228-762-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "PHILLIPS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "155773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00062943",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Techksell McKnight Washington, MD, MPH
• Dewey Dewayne Watkins, MS, LPC
• Benjamin P Watts, M.H.S., PA-C
• Joel H Watts, M.D.
• Gregory Wawryszczuk, M.D.
• Brittany N Welford
• Kizzie Wells-Daniels, LICENSED COUNSELOR
• Shawnna Wells, ACNP
• Torre Wells, OT
• Fang Q Weng, M.D.

• Dentist in Pascagoula, MS
• Providers in Pascagoula, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.