Individual provider Active NPI

Jonathan D. Weimer, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1528596343
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2744 Issued in SC
Practice address
5325 Appian Way
Charleston, SC 29420-7234
Phone
(843) 552-0400
Fax
(843) 552-1618
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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 2744 SC Primary

Addresses

Primary practice location

5325 Appian Way
Charleston, SC 29420-7234

Mailing address

201 Sigma Dr Ste 100
Summerville, SC 29486-7722
Phone (843) 552-0400

Other identifiers 1

IdentifierTypeStateIssuer
2998PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20170803003653 SC Practitioner - Physician Assistant 4183995442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Primary Care Physicians LLCGroup PAC ID 4880508068, 148 clinicians

Practice addresses (Care Compare)

1401 Main St
Bonneau, SC 29431-5013
Phone (843) 695-6071

5325 Appian Way
Charleston, SC 29420-7234
Phone (843) 695-6071

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079
  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2744SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC CurrentSince Jun 12, 2017 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Jun 12, 2017 Accepting new patients
Palmetto Primary Care Physicians, LLC Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

5325 Appian Way
Charleston, SC 29420
Phone (843) 552-0400

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

Interoperability endpoints

  • Direct secure messaging: jonathan.weimer@ppcp1.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1528596343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIGMA DR STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867722",
            "telephone_number": "843-552-0400",
            "fax_number": "843-552-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 APPIAN WAY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294207234",
            "telephone_number": "843-552-0400",
            "fax_number": "843-552-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "JONATHAN",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2998PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.