Individual provider Active NPI

Valleri D. Weyant, PA

  • Physician Assistant
  • Severna Park, MD
National Provider Identifier
1497846570
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002305 Issued in MD
Practice address
479 Jumpers Hole Rd
Suite 304
Severna Park, MD 21146-1600
Phone
(410) 573-9191
Fax
(410) 573-5910
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 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 C0002305 MD Primary

Addresses

Primary practice location

479 Jumpers Hole Rd
Suite 304
Severna Park, MD 21146-1600

Mailing address

479 Jumpers Hole Rd
Suite 304
Severna Park, MD 21146-1600
Phone (410) 573-9191

Other practice location 1

621 Ridgely Ave Ste 401
Annapolis, MD 21401-1099
Phone (410) 573-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20050414000939 MD Practitioner - Physician Assistant 4789621368 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0002305MDMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1497846570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 JUMPERS HOLE RD",
            "address_2": "SUITE 304",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461600",
            "telephone_number": "410-573-9191",
            "fax_number": "410-573-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 JUMPERS HOLE RD",
            "address_2": "SUITE 304",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461600",
            "telephone_number": "410-573-9191",
            "fax_number": "410-573-5910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Ridgely Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214011099",
            "country_code": "US",
            "telephone_number": "410-573-9191",
            "fax_number": "410-573-5910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEYANT",
        "first_name": "VALLERI",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.