NPIMap

Individual provider Active NPI

Marissa Copas Weaver

  • Internal Medicine Physician
  • Rapid City, SD
National Provider Identifier
1760059703
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17712 Issued in SD
Practice address
640 Flormann St
Rapid City, SD 57701-4679
Phone
(605) 755-3300
NPI assigned
Jun 8, 2021
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17712 SD Primary
Pediatrics Physician 208000000X 17712 SD

Addresses

Primary practice location

640 Flormann St
Rapid City, SD 57701-4679

Mailing address

640 Flormann St
Rapid City, SD 57701-4679
Phone (605) 755-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251106002032 SD Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7214331909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17712SDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Oct 1, 2025 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Oct 1, 2025 Accepting new patients
Regional Health Physicians Inc Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

640 Flormann St
Rapid City, SD 57701
Phone (605) 341-3140

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1760059703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 FLORMANN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014679",
            "telephone_number": "605-755-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 FLORMANN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014679",
            "telephone_number": "605-755-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPAS WEAVER",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "17712",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "17712",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.