Individual provider Active NPI

Christopher D Weaver, RN

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
National Provider Identifier
1629134978
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
12442 Issued in TN
Practice address
708 W Forest Ave
Jackson, TN 38301-3901
Phone
(731) 927-7070
Fax
(731) 927-7075
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 12442 TN Primary

Addresses

Primary practice location

708 W Forest Ave
Jackson, TN 38301-3901

Mailing address

810 W Forest Ave
Jackson, TN 38301-3942
Phone (731) 668-1853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070425000644 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901902600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

700 W Forest Ave
Suite 100
Jackson, TN 38301-3940
Phone (731) 661-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
12442TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesia Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 6, 2013 Accepting new patients
Northstar Anesthesia of Tennessee, PLLC CurrentSince Mar 28, 2012 Accepting new patients
Jackson Anesthesiology Group, PLLC PastSince Dec 6, 2020 Accepting new patients

Locations

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

Organizations & group practices 3

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1629134978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013942",
            "telephone_number": "731-668-1853",
            "fax_number": "731-664-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013901",
            "telephone_number": "731-927-7070",
            "fax_number": "731-927-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "12442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.