Individual provider Active NPI

Joey Matthew Weaver, O.D.

  • Optometrist
  • Vienna, WV
National Provider Identifier
1760414312
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
883-OD Issued in WV
Practice address
900 Grand Central Ave
Suite C
Vienna, WV 26105-2147
Phone
(304) 699-4540
Fax
(304) 295-7822
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 883-OD WV Primary

Addresses

Primary practice location

900 Grand Central Ave
Suite C
Vienna, WV 26105-2147

Mailing address

900 Grand Central Ave
Suite C
Vienna, WV 26105-2147
Phone (304) 699-4540

Other identifiers 1

IdentifierTypeStateIssuer
0149600000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000337 WV Practitioner - Optometry 7416088893 Practice locations: Vienna, WV

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

900 Grand Central Ave
Suite C
Vienna, WV 26105-2191
Phone (304) 699-4540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
883-ODWVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
M F Anwar MD Inc Optometrist Past Accepting new patients
M F Anwar MD Inc Optometrist Past Accepting new patients
M F Anwar MD Inc Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1760414312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 GRAND CENTRAL AVE",
            "address_2": "SUITE C",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261052147",
            "telephone_number": "304-699-4540",
            "fax_number": "304-295-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 GRAND CENTRAL AVE",
            "address_2": "SUITE C",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261052147",
            "telephone_number": "304-699-4540",
            "fax_number": "304-295-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JOEY",
        "middle_name": "MATTHEW",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "883-OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149600000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

Verify at the official NPI Registry.