Active NPI
Jack David Weaver, DC
- Chiropractor
- Redding, CA
National Provider Identifier
1558342154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC10695
- Practice address
- 3051 Victor Ave
Redding, CA 96002-1450 - Phone
- (530) 223-0583
- Fax
- (530) 223-6316
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC10695 | CA | Primary |
Addresses
Primary practice location
3051 Victor Ave
Redding, CA 96002-1450
Mailing address
PO Box 492725
3051 Victor Avenue
Redding, CA 96002
Phone (530) 223-0583
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC10695 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Work Comp Only | 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.
-
- Orthopedic Chiropractor
- Redding, CA
- NPI 1245388990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1558342154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 492725",
"address_2": "3051 VICTOR AVENUE",
"city": "REDDING",
"state": "CA",
"postal_code": "96002",
"telephone_number": "530-223-0583",
"fax_number": "530-223-6316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3051 VICTOR AVE",
"city": "REDDING",
"state": "CA",
"postal_code": "960021450",
"telephone_number": "530-223-0583",
"fax_number": "530-223-6316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "JACK",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC10695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.