Individual provider Active NPI

Ronald S Weaver, M.D.

  • Internal Medicine Physician
  • Inglewood, CA
National Provider Identifier
1669465928
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
WG30188A Issued in CA
Practice address
633 Aerick St
Suite 101
Inglewood, CA 90301-1978
Phone
(310) 412-8181
Fax
(310) 412-9299
NPI assigned
Aug 23, 2005
Reactivated
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G30118 CA
Internal Medicine Physician 207R00000X WG30188A CA Primary

Addresses

Primary practice location

633 Aerick St
Suite 101
Inglewood, CA 90301-1978

Mailing address

633 Aerick St
Suite 101
Inglewood, CA 90301-1978
Phone (310) 412-8181

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
WG30188ACAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Elkin MD Inc Past Accepting new patients
Cytology Associates of Houston Past Accepting new patients

Organizations & group practices 2

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1669465928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 AERICK ST",
            "address_2": "SUITE 101",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011978",
            "telephone_number": "310-412-8181",
            "fax_number": "310-412-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 AERICK ST",
            "address_2": "SUITE 101",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011978",
            "telephone_number": "310-412-8181",
            "fax_number": "310-412-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "RONALD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2013-08-14",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30118",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "WG30188A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.