Active NPI
Marilee Weaver, D.M.D.
- Dentist
- Charlotte, NC
National Provider Identifier
1477840593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 19358
- Practice address
- 6433 Creola Rd
Charlotte, NC 28226 - Phone
- (386) 871-9702
- NPI assigned
- Jul 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN 19358 | FL | Primary |
Addresses
Primary practice location
6433 Creola Rd
Charlotte, NC 28226
Mailing address
6433 Creola Rd
Charlotte, NC 28226-4100
Phone (386) 871-9702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160725000134 | FL | Order and Referring Only - Dentist | 6002109352 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 19358 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1477840593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6433 CREOLA RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282264100",
"telephone_number": "386-871-9702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6433 CREOLA RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28226",
"telephone_number": "386-871-9702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "MARILEE",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-10",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 19358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; 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.