Alan M Weaver, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R8G92 Issued in MO

Practice address

208 N Ogden St
Sturgeon, MO 65284-9217

Phone

(573) 687-3411

Fax

(573) 687-3328

NPI assigned

Oct 10, 2005

Last updated

Aug 12, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sturgeon Medical Clinic PC

  • Family Medicine Physician
  • Sturgeon, MO
  • NPI 1528411527
  Authorized official Same address or phone
• Tri County Medical Clinic P C

  • Primary Care Clinic/Center
  • Sturgeon, MO
  • NPI 1639317050
  Authorized official Same address or phone
• Moberly Medical Clinics Inc

  • Multi-Specialty Clinic/Center
  • Moberly, MO
  • NPI 1336135607
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1407844962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 W THORNHILL RD",
            "city": "CLARK",
            "state": "MO",
            "postal_code": "652439381",
            "telephone_number": "573-641-5019",
            "fax_number": "573-687-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N OGDEN ST",
            "city": "STURGEON",
            "state": "MO",
            "postal_code": "652849217",
            "telephone_number": "573-687-3411",
            "fax_number": "573-687-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "ALAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R8G92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242429009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sturgeon Medical Clinic PC
• Sturgeon R-V School
• Sturgeon Rest Home, LLC
• Sturgeon Rest Residential Care LLC
• Tri County Medical Clinic P C

• Family Medicine Physician in Sturgeon, MO
• Providers in Sturgeon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.