NPIMap

Individual provider Active NPI

Shannon Weaver

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1457903791
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10539 Professional Cir Ste 200
Reno, NV 89521-3858
Phone
(775) 851-5700
Fax
(775) 515-4462
NPI assigned
Jul 16, 2019
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NV Primary

Addresses

Primary practice location

10539 Professional Cir Ste 200
Reno, NV 89521-3858

Mailing address

954 Solarium Dr
Reno, NV 89511-7309
Phone (231) 313-6336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201030000840 NV Practitioner - Physician Assistant 8729498811 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CTH Physicians ClinicGroup PAC ID 1254787203, 107 clinicians
Carson Tahoe Physician ClinicsGroup PAC ID 1153479027, 104 clinicians

Practice addresses (Care Compare)

2874 N Carson St
Suite 120
Carson City, NV 89706-1681
Phone (775) 445-5181

2874 N Carson St
Suite 200
Carson City, NV 89706-1682
Phone (775) 445-7170

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Tahoe Physician Clinics CurrentSince Mar 31, 2025 Accepting new patients
CTH Physicians Clinic CurrentSince Dec 1, 2025 Accepting new patients

Locations

2874 N Carson St
Ste 120
Carson City, NV 89706
Phone (775) 445-5181

2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220

901 Medical Center Dr
Ste 203
Dayton, NV 89403
Phone (775) 445-7630

10539 Professional Cir
Ste 200
Reno, NV 89521
Phone (775) 445-7026

Interoperability endpoints

  • Direct secure messaging: shannon.weaver@rfp.directbygreenway.com
  • Direct secure messaging: sweaver740486@direct.med.utah.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1457903791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 SOLARIUM DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895117309",
            "telephone_number": "231-313-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10539 PROFESSIONAL CIR STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895213858",
            "telephone_number": "775-851-5700",
            "fax_number": "775-515-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.