Active NPI
Howard A Weaver, M.D.
- Gastroenterology Physician
- Rutland, VT
National Provider Identifier
1790741130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 042-0004441
- Practice address
- 1 Albert Cree Dr
Rutland, VT 05701 - Phone
- (802) 786-1400
- Fax
- (802) 786-1405
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 042-0004441 | VT | Primary |
Addresses
Primary practice location
1 Albert Cree Dr
Rutland, VT 05701
Mailing address
160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111
Other practice location 1
254 Stratton Rd
Suite 2
Rutland, VT 05701-4675
Phone (802) 775-5531
Other practice location 2
160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004728 | Medicaid | VT | |
| 04728 | Other | VT | BCBS |
| 1752688 | Other | CIGNA | |
| 10138 | Other | MVP |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0004441 | VT | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1790741130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 ALLEN ST",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014560",
"telephone_number": "802-775-7111",
"fax_number": "802-786-1405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ALBERT CREE DR",
"city": "RUTLAND",
"state": "VT",
"postal_code": "05701",
"telephone_number": "802-786-1400",
"fax_number": "802-786-1405"
}
],
"practiceLocations": [
{
"address_1": "254 Stratton Rd",
"address_2": "SUITE 2",
"address_purpose": "LOCATION",
"city": "Rutland",
"state": "VT",
"postal_code": "057014675",
"country_code": "US",
"telephone_number": "802-775-5531",
"fax_number": "802-773-4697",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "160 Allen St",
"address_purpose": "LOCATION",
"city": "Rutland",
"state": "VT",
"postal_code": "057014560",
"country_code": "US",
"telephone_number": "802-775-7111",
"fax_number": "802-786-1405",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEAVER",
"first_name": "HOWARD",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "VT",
"license": "042-0004441",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004728",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "04728",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1752688",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "10138",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.