Jared Jerel Weaver, CAREGIVER

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

210 Foxlake Dr
Statesboro, GA 30458-4400

Phone

(912) 536-6679

Fax

(912) 536-6679

NPI assigned

Jun 12, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1407471741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FOXLAKE DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584400",
            "telephone_number": "912-536-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FOXLAKE DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584400",
            "telephone_number": "912-536-6679",
            "fax_number": "912-536-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JARED",
        "middle_name": "JEREL",
        "name_prefix": "Mr.",
        "credential": "CAREGIVER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Watkins, RN
• Sebrina Madelyn Watkins, PA-C
• James Daniel Weathers, M.D.
• Trevor Weathersby, CRNA
• Chelsea Alexus Weaver, MED. LPC.
• Reese Morgan Weber
• David Hale Weems, M.D.
• Olivia Katherine Welch
• Joy Welcker, PH.D.
• Wellness One LLC

• Attendant Care Provider in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Attendant Care Provider in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.