Stephen Alexander Weaver, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

7567896-3102 Issued in UT

Practice address

1852 E Meadow Downs Way
Cottonwood Heights, UT 84121-2920

Phone

(801) 722-8758

NPI assigned

Sep 5, 2021

Last updated

Sep 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630800000000",
    "number": "1538837315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1852 E MEADOW DOWNS WAY",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841212920",
            "telephone_number": "801-722-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 E MEADOW DOWNS WAY",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841212920",
            "telephone_number": "801-722-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "STEPHEN",
        "middle_name": "ALEXANDER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-05",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "UT",
            "license": "7567896-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Administrator Registered Nurse in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Administrator Registered Nurse in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; 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.