Active NPI
Kelly Weaver
- Pharmacist
- Seagoville, TX
National Provider Identifier
1528684750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36870
- Practice address
- 125 Hall Rd
Seagoville, TX 75159-2915 - Phone
- (972) 287-1680
- Fax
- (972) 287-2269
- NPI assigned
- Jun 23, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36870 | TX | Primary |
Addresses
Primary practice location
125 Hall Rd
Seagoville, TX 75159-2915
Mailing address
2800 W Hwy 22
Corsicana, TX 75110
Phone (903) 872-3784
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36870 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kellyweaver@brookshires.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36870 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Pharmacy LLC | Past | Accepting new patients |
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": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1528684750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 W HWY 22",
"city": "CORSICANA",
"state": "TX",
"postal_code": "75110",
"telephone_number": "903-872-3784",
"fax_number": "903-872-3791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 HALL RD",
"city": "SEAGOVILLE",
"state": "TX",
"postal_code": "751592915",
"telephone_number": "972-287-1680",
"fax_number": "972-287-2269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-23",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "36870",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF PHARMACY",
"identifier": "36870",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kellyweaver@brookshires.com",
"affiliation": "N",
"endpointDescription": "kellyweaver@brookshires.com",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "125 Hall Rd",
"city": "Seagoville",
"state": "TX",
"country_code": "US",
"postal_code": "751592915",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seagoville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.