NPIMap

Individual provider Active NPI

Jordan Taylor Weakley, PA

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1609455518
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115029 Issued in FL
Practice address
1 Davis Blvd Ste 604
Tampa, FL 33606-3480
Phone
(813) 356-0196
Fax
(813) 356-0197
NPI assigned
Apr 7, 2021
Last updated
May 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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 PA9115029 FL Primary

Addresses

Primary practice location

1 Davis Blvd Ste 604
Tampa, FL 33606-3480

Mailing address

1 Davis Blvd Ste 604
Tampa, FL 33606-3480
Phone (813) 356-0196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220111000732 FL Practitioner - Physician Assistant 4082006671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Urology Partners LLPGroup PAC ID 2062574924, 66 clinicians

Practice addresses (Care Compare)

1 Davis Blvd
Suite 604
Tampa, FL 33606-3480
Phone (813) 258-9565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Florida Urology Partners, LLP CurrentSince Oct 20, 2025 Accepting new patients
Trevecca Nazarene University PastSince Apr 1, 2021 Accepting new patients
Florida Urology Partners LLP PastSince Nov 17, 2019 Accepting new patients
Tampa General Provider Network Inc PastSince Jun 1, 2022 Accepting new patients

Locations

3140 S Falkenburg Rd
Ste 203
Riverview, FL 33578
Phone (813) 850-0026

1 Davis Blvd
Ste 604
Tampa, FL 33606
Phone (813) 258-9565

1209 W Swann Ave
Tampa, FL 33606
Phone (813) 253-3007

5015 W Nassau St
Tampa, FL 33607
Phone (813) 356-0196

12408 N 56th St
Ste 1
Temple Terrace, FL 33617
Phone (813) 980-3104

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jstory294489@orlandohealth.medalliesdirect.net
  • Direct secure messaging: jweakley365662@direct.tgh.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1609455518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DAVIS BLVD STE 604",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063480",
            "telephone_number": "813-356-0196",
            "fax_number": "813-356-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DAVIS BLVD STE 604",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063480",
            "telephone_number": "813-356-0196",
            "fax_number": "813-356-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAKLEY",
        "first_name": "JORDAN",
        "middle_name": "TAYLOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.