NPIMap

Individual provider Active NPI

David Weaver, DO

  • Emergency Medicine Physician
  • Canton, MI
National Provider Identifier
1720067606
Registry record updated Sep 22, 2016
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jan 19, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101008321 Issued in MI
Practice address
7300 N Canton Center Rd
Emergency Medicine Department
Canton, MI 48187-1579
Phone
(734) 454-8002
Fax
(734) 454-2733
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101008321 MI Primary
Emergency Medicine Physician 207P00000X 0102202236 VA
Emergency Medicine Physician 207P00000X OS014356 PA
Internal Medicine Physician 207R00000X 5101008321 MI

Addresses

Primary practice location

7300 N Canton Center Rd
Emergency Medicine Department
Canton, MI 48187-1579

Mailing address

29150 Buckingham St
Suite 6
Livonia, MI 48154-7502
Phone (734) 207-9999

Other identifiers 2

IdentifierTypeStateIssuer
1720067606MedicaidMI
11293324OtherCAQH

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS014356PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Care, PC Emergency Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1720067606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29150 BUCKINGHAM ST",
            "address_2": "SUITE 6",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481547502",
            "telephone_number": "734-207-9999",
            "fax_number": "734-838-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 N CANTON CENTER RD",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871579",
            "telephone_number": "734-454-8002",
            "fax_number": "734-454-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101008321",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102202236",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS014356",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101008321",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720067606",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11293324",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.