Active NPI
Kerry E Weaver
- Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1720624406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN11017050
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN9424439 | FL | MD | Registered Nurse |
| APRN11017050 | FL | MD | Nurse Practitioner |
| GAA-NP002170 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
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.