Charles Edward Weaver Jr., MD PHD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

56242 Issued in GA

Practice address

470 Northside Cherokee Blvd Ste 170
Canton, GA 30115-8029

Phone

(770) 721-9540

Fax

(770) 721-9541

NPI assigned

May 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurosurgery

Education

Boston University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Kennesaw, GA, CCN 117149
• Amedisys Northwest Home Health Home health agency, Jasper, GA, CCN 117064
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score

79.79 of 100Reported as individual

Quality

76.22

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.weaver@northsidehospital.cernerdirect.com
• Direct secure messaging: cweaver382429@directwellstar.org
• Direct secure messaging: charles.weaver.p96@direct.tenet.nextgenshare.com

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990

  GA

  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  GA

  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Austell, GA
  • NPI 1134425283
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

• Amedisys Northwest, L.L.C.

  • Home Health Agency
  • Jasper, GA
  • NPI 1588612188
  Care Compare affiliation
• Caresouth HHA Holdings of Gainesville, LLC

  • Home Health Agency
  • Kennesaw, GA
  • NPI 1720435829
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1116979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1801899554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "STE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764947",
            "telephone_number": "770-664-9600",
            "fax_number": "770-664-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD STE 170",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158029",
            "telephone_number": "770-721-9540",
            "fax_number": "770-721-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-25",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "56242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642893452A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA",
            "identifier": "854350",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHARLES.WEAVER@northsidehospital.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "470 Northside Cherokee Blvd Ste 170",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301158029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marina Ward, PHARM D
• Stacy Ward, HWC
• Nojoud Warrayat
• Nerka Lavette Watkins-Graham, MD
• Ashley Weaver
• Courtney Weaver
• Juelle Everne Christie Weekes, M.D.
• Mercy E. Weiler, APRN
• Weiner Eye Center, LLC
• Mark J Weiner, M.D.

• All providers in Canton, GA
• Neurological Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.