Beverly P. Weaver, RN, MSN, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R629189 Issued in MS

Practice address

3451 Goodman Rd E
Ste 115
Southaven, MS 38672-9303

Phone

(662) 890-5555

Fax

(662) 890-8899

NPI assigned

May 15, 2006

Last updated

Jun 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Family Medical Clinic of North Ms Inc

  • Family Medicine Physician
  • Southaven, MS
  • NPI 1134174154
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1831140508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 GOODMAN RD W",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371416",
            "telephone_number": "662-429-4988",
            "fax_number": "662-429-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E",
            "address_2": "STE 115",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729303",
            "telephone_number": "662-890-5555",
            "fax_number": "662-890-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2085 Goodman Rd W",
            "address_purpose": "LOCATION",
            "city": "Horn Lake",
            "state": "MS",
            "postal_code": "386371416",
            "country_code": "US",
            "telephone_number": "662-280-7455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "BEVERLY",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R629189",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R629189",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122952",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Wayne Washburn III
• Naya Washington, LMSW
• Magdi S Wassef, M.D.
• Katherine Watson, DO
• Callie Claire Watts, CCC-SLP
• Dawn Webb, FNP
• William Jacob Weller, M.D.
• Wellness Clinic, P.C.
• Chelcey Rennee Wells
• Kenji Jermaine Wells

• Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.