Individual provider Active NPI

Sam Weaver, DC

  • Chiropractor
  • Lee's Summit, MO
National Provider Identifier
1710504477
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2020013203 Issued in MO
Practice address
338 SW Main St
Lees Summit, MO 64063-2340
Phone
(816) 600-5483
Fax
(816) 524-5328
NPI assigned
Jun 29, 2020
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-06112 KS
Chiropractor 111N00000X 2020013203 MO Primary

Addresses

Primary practice location

338 SW Main St
Lees Summit, MO 64063-2340

Mailing address

8345 Renner Blvd Apt 3416
Lenexa, KS 66219-3068
Phone (816) 808-2539

Other names 1

  • Dr. Summer Weaver Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230310001845 MO Practitioner - Chiropractic 9931515137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Sports and Family Chiropractic, LLCGroup PAC ID 7517036023, 17 clinicians

Practice addresses (Care Compare)

338 SW Main St
Lees Summit, MO 64063-2340
Phone (816) 600-5483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Sports and Family Chiropractic, LLC Chiropractor CurrentSince Dec 8, 2022 Accepting new patients

Locations

10454 S Ridgeview Rd
Olathe, KS 66061
Phone (913) 643-1771

6701 W 121st St
Ste 200
Overland Park, KS 66209
Phone (913) 379-9550

338 SW Main St
Lees Summit, MO 64063
Phone (816) 600-5483

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1710504477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8345 RENNER BLVD APT 3416",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662193068",
            "telephone_number": "816-808-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 SW MAIN ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632340",
            "telephone_number": "816-600-5483",
            "fax_number": "816-524-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-06112",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2020013203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUMMER",
            "last_name": "WEAVER",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.