Danelle Weaver, ADULT NP-BC,PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9227262 Issued in FL

Practice address

4624 Park St
Jacksonville, FL 32205-7327

Phone

(904) 503-0131

NPI assigned

Oct 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Danielle Weaver Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  NPD
• St Vincents Ambulatory Care Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Tsi Health, LLC

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1548757693
  NPD

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1477807444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 CLIFTON AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116901",
            "telephone_number": "850-896-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057327",
            "telephone_number": "904-503-0131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Prudential Dr Ste 112",
            "address_2": "Baptist Heart Specialists",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078204",
            "country_code": "US",
            "telephone_number": "904-396-5996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Shircliff Way",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044748",
            "country_code": "US",
            "telephone_number": "904-308-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "DANELLE",
        "credential": "ADULT NP-BC,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9227262",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9227262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102378500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.tsihealthjax.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4624 Park St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322057327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "WEAVER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Katherine Elza Weatherspoon, MSW
• Alex Cameron Weaver, MD
• Ashley Weaver
• Catherine J. Weaver, APRN
• Damone J Weaver
• Desiree Dawn Weaver, PHARM D
• Erika Weaver
• James Patrick Weaver, D.M.D.
• Jodeci Weaver
• Kerry E Weaver

• Psychiatric/Mental Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.