Russell Martin Weaver, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11259 Issued in NC

Practice address

10564 S US Highway 15 501 Ste D
Southern Pines, NC 28387

Phone

(910) 725-3216

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rweaver610249@direct.unc.nchie.net

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508842816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10564 S US HIGHWAY 15 501 STE D",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875166",
            "telephone_number": "910-725-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10564 S US HIGHWAY 15 501 STE D",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "28387",
            "telephone_number": "910-725-3216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2997 Hope Mills Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283068349",
            "country_code": "US",
            "telephone_number": "910-493-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "RUSSELL",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401410877",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "11259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Whitfield Wannamaker Jr., M.D.
• Terry Theo Warner, M.S.
• Grace Warren
• Helga Wartena
• Elizabeth M Watson, PMH-NP
• Thomas Raymond Weber, PA-C
• Hanna Wellman, LMT
• April Werner
• Caitlin Newby Whitaker, PTA
• Benjamin Alexander White Jr., DDS

• Orthodontics and Dentofacial Orthopedics Dentistry in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.