Lydia M Weaver, APRN-CNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

28264 Issued in SC

Practice address

440 Knox Abbott Dr Ste 400
Cayce, SC 29033-4353

Phone

(843) 501-1099

NPI assigned

May 8, 2009

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

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.

• Charleston Counseling Center PC

  dba Lifestance Health

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678
  Medicare reassignment NPD
• Phoenix Group Home, LLC

  dba PATH Integrated Healthcare

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD (past)
• Phoenix Group Home, LLC

  dba Path Behavioral Health- SUD

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD (past)

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1457585234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 BURKHARDT RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454312111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 KNOX ABBOTT DR STE 400",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290334353",
            "telephone_number": "843-501-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 W Union St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012312",
            "country_code": "US",
            "telephone_number": "740-764-4529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "LYDIA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "APRN-CNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.335652",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0033630",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "28264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Briana Pittman Wages, DNP
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5378)
• Marika Waller
• Cynthia Harris Ware, LPCA
• Willie Washington
• Lynn Grube Wellman, MS, APRN
• Felicia B Wesley, BSN
• Holly May Wheeling, MD
• Lauryn Williams, LMSW
• Marco Fukuyama Williams, MA

• Psychiatric/Mental Health Nurse Practitioner in Cayce, SC
• Providers in Cayce, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.