NPIMap

Organization Active NPI

Weaver Neurosurgical Spine, PC

  • Neurological Surgery Physician
  • Roanoke, VA
National Provider Identifier
1831482264
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
0101033189 Issued in VA
Legal business name
WEAVER NEUROSURGICAL SPINE, PC
Practice address
5304 Indian Grave Rd
Suite a
Roanoke, VA 24018-9100
Phone
(540) 772-7107
Fax
(540) 772-7858
NPI assigned
May 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Authorized official

Name
Edgar Newman Weaver Jr., MD
Title
President
Phone
(540) 772-7107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 0101033189 VA Primary

Addresses

Primary practice location

5304 Indian Grave Rd
Suite a
Roanoke, VA 24018-9100

Mailing address

5304 Indian Grave Rd
Suite a
Roanoke, VA 24018-9100
Phone (540) 772-7107

Other identifiers 1

IdentifierTypeStateIssuer
6196705MedicaidVA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1831482264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 INDIAN GRAVE RD",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240189100",
            "telephone_number": "540-772-7107",
            "fax_number": "540-772-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 INDIAN GRAVE RD",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240189100",
            "telephone_number": "540-772-7107",
            "fax_number": "540-772-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEAVER NEUROSURGICAL SPINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "NEWMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-772-7107",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101033189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6196705",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.