Individual provider Active NPI

Kerry E Weaver

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1720624406
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11017050 Issued in FL
Practice address
807 Childrens Way
Jacksonville, FL 32207-8426
Phone
(904) 697-3600
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11017050 FL Primary
Registered Nurse 163W00000X RN9424439 FL
Nurse Practitioner 363L00000X GAA-NP002170 GA

Addresses

Primary practice location

807 Childrens Way
Jacksonville, FL 32207-8426

Mailing address

1503 Parrish PL
Jacksonville, FL 32205-9247

Other practice location 1

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 202-2000

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9424439FLMDRegistered Nurse
APRN11017050FLMDNurse Practitioner
GAA-NP002170GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kweaver83604@direct.nemours.org

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1720624406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 PARRISH PL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322059247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "telephone_number": "904-697-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Prudential Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078202",
            "country_code": "US",
            "telephone_number": "904-202-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KERRY",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11017050",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9424439",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP002170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.