Active NPI
Dexter Javair Weaver, MS
- Counselor
- Milwaukee, WI
National Provider Identifier
1396979241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- WI60000593097
- Practice address
- 6815 W Capitol Dr
Suite 208
Milwaukee, WI 53216-2070 - Phone
- (414) 466-3204
- Fax
- (414) 466-3206
- NPI assigned
- May 6, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | WI60000593097 | WI | Primary |
Addresses
Primary practice location
6815 W Capitol Dr
Suite 208
Milwaukee, WI 53216-2070
Mailing address
6815 W Capitol Dr
Suite 208
Milwaukee, WI 53216-2070
Phone (414) 466-3204
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WI60000593097 | WI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1396979241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6815 W CAPITOL DR",
"address_2": "SUITE 208",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532162070",
"telephone_number": "414-466-3204",
"fax_number": "414-466-3206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6815 W CAPITOL DR",
"address_2": "SUITE 208",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532162070",
"telephone_number": "414-466-3204",
"fax_number": "414-466-3206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "DEXTER",
"middle_name": "JAVAIR",
"name_prefix": "Mr.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-06",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "WI60000593097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.