Active NPI
Darla Joan Weaver, PT
- Pediatric Physical Therapist
- Paris, AR
National Provider Identifier
1790904191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT1447
- Practice address
- 1414 S Elm St
Paris, AR 72855-4924 - Phone
- (479) 963-6151
- Fax
- (479) 963-3331
- NPI assigned
- Apr 24, 2007
- Last updated
- Jul 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1447 | AR | |
| Pediatric Physical Therapist | 2251P0200X | PT1447 | AR | Primary |
Addresses
Primary practice location
1414 S Elm St
Paris, AR 72855-4924
Mailing address
227 Dubbs Way
Booneville, AR 72927-7849
Phone (479) 675-2898
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128029721 | Medicaid | AR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT1447 | AR | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247184000000",
"number": "1790904191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 DUBBS WAY",
"city": "BOONEVILLE",
"state": "AR",
"postal_code": "729277849",
"telephone_number": "479-675-2898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 S ELM ST",
"city": "PARIS",
"state": "AR",
"postal_code": "728554924",
"telephone_number": "479-963-6151",
"fax_number": "479-963-3331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "DARLA",
"middle_name": "JOAN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2009-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT1447",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AR",
"license": "PT1447",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128029721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paris, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.