Paul Douglas Weaver, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11887 Issued in SC

Practice address

1690 Skylyn Dr
Suite 300
Spartanburg, SC 29307-1022

Phone

(864) 582-1201

Fax

(864) 596-7409

NPI assigned

Jan 10, 2006

Last updated

Jan 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pweaver8463@direct-srhs.et0939.epichosted.com

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.

• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Emergency Medicine

  • Emergency Medicine Physician
  • Spartanburg, SC
  • NPI 1699729939
  Medicare reassignment NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Internal Medicine - Eastside

  • Internal Medicine Physician
  • Spartanburg, SC
  • NPI 1801206123
  NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas Pain Management Wood Street

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Mary Black Health System LLC

  dba Mary Black Memorial Hospital

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1083640981
  NPD (past)
• Mary Black Health System LLC

  dba Mary Black Health System Spartanburg

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1992758296
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1689653578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071052",
            "telephone_number": "864-582-1201",
            "fax_number": "864-596-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 SKYLYN DR",
            "address_2": "SUITE 300",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071022",
            "telephone_number": "864-582-1201",
            "fax_number": "864-596-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "PAUL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "11887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1628",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pweaver8463@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pweaver8463@direct-srhs.et0939.epichosted.com",
            "address_1": "118 Dillon Dr",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293071018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Watters, NP
• Kenny Ray Watts
• Wayne Hyatt Counseling, LLC (WholeLife Family Therapy)
• William Travis Weathers, M.D.
• Linda Kay Weaver, LM, CPM
• Tylesa Webb
• Tabitha Weber, LISW-CP
• Julie S Webster, MD
• Victoria R Weekley, SLP
• James Patrick Weeks, M.D.

• Internal Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.