NPIMap

Organization Active NPI

Kimberly M. Weaver, MD, PC

  • Obstetrics & Gynecology Physician
  • Duncan, OK
National Provider Identifier
1639307481
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
24587 Issued in OK
Legal business name
KIMBERLY M. WEAVER, MD, PC
Practice address
1312 North Harville Rd
Duncan, OK 73533
Phone
(580) 470-9800
Fax
(580) 470-9802
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Dr. Kimberly M Weaver, M.D.NPI 1194861021
Title
Owner
Phone
(580) 470-9800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 24587 OK Primary

Addresses

Primary practice location

1312 North Harville Rd
Duncan, OK 73533

Mailing address

1312 North Harville Rd
Duncan, OK 73533
Phone (580) 470-9800

Other names 1

  • Kimberly M. Hennan, MD, PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000841 OK Part B Supplier - Clinic/Group Practice 0840344131 Receives reassigned benefits from 5 practitioners
Practice locations: Norman, OK; Lawton, OK; Chickasha, OK; Ardmore, OK; Duncan, OK

National Provider Directory

National Provider Directory

Locations

1019 15th Ave NW
Ardmore, OK 73401
Phone (580) 226-0100

512 W Chickasha Ave
Chickasha, OK 73018

910 SW 38th St
Ste B
Lawton, OK 73505
Phone (580) 355-7443

2921 Adams Rd
Ste 111
Norman, OK 73069

1125 N Porter Ave
Ste 305
Norman, OK 73071

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1639307481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 NORTH HARVILLE RD",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "73533",
            "telephone_number": "580-470-9800",
            "fax_number": "580-470-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 NORTH HARVILLE RD",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "73533",
            "telephone_number": "580-470-9800",
            "fax_number": "580-470-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY M. WEAVER, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-470-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "24587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimberly M. Hennan, MD, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Duncan, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.