Tara Ann Weaver

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6140 Issued in SC

Practice address

1600 Lake Murray Blvd
Columbia, SC 29212-8623

Phone

(803) 731-9600

NPI assigned

Nov 14, 2025

Sex

Female

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

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Dermatology LLCGroup PAC ID 5698086460, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Columbia Dermatology LLC

  • Dermatology Physician
  • Columbia, SC
  • NPI 1417349747
  Medicare reassignment Care Compare group NPD
• Center for Vein Restoration SC LLC

  • Surgery Physician
  • Columbia, SC
  • NPI 1295391498
  NPD (past)

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1609736453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WHITE BIRCH CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290736905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKE MURRAY BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128623",
            "telephone_number": "803-731-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "TARA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "6140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlondra Weaver, PA
• Audrey Weaver
• Gary S Weaver, DC
• Jabe Kinnis Weaver, PHARM.D.
• Kylie Michelle Weaver, PHARMD
• William Thayer Weaver, LMSW
• Kimberly Sherese Webb, CLC
• Kristin Webb, NP
• Lee Ann Webb, NP
• Morgan KC Webb

• Medical Physician Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.