NPIMap

Individual provider Active NPI

John Dudley Weaver, MD

  • Family Medicine Physician
  • Johnson City, TX
National Provider Identifier
1841248408
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G8495 Issued in TX
Practice address
405 S US Highway 281
Ste 101C
Johnson City, TX 78636-4950
Phone
(830) 868-7800
Fax
(830) 992-2861
NPI assigned
May 5, 2006
Last updated
Jan 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G8495 TX Primary

Addresses

Primary practice location

405 S US Highway 281
Ste 101C
Johnson City, TX 78636-4950

Mailing address

205 W Windcrest St
Ste 130
Fredericksburg, TX 78624-4478
Phone (830) 990-6631

Other identifiers 1

IdentifierTypeStateIssuer
133026802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804001049 TX Practitioner - Family Practice 0446269229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

825 4TH St
Blanco, TX 78606-4913
Phone (830) 833-5581

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.35 of 100Reported as apm
Quality
58.35
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions32
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G8495TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blanco Regional Clinic, P.a. Family Medicine CurrentSince Mar 5, 1987 Accepting new patients
Blanco Regional Clinic Family Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Hamilton County Hospital District Past Accepting new patients

Locations

825 4th St
Blanco, TX 78606
Phone (361) 882-7300

405 S US Highway 281
Ste 101C
Johnson City, TX 78636
Phone (830) 868-4280

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1841248408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WINDCREST ST",
            "address_2": "STE 130",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244478",
            "telephone_number": "830-990-6631",
            "fax_number": "830-990-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S US HIGHWAY 281",
            "address_2": "STE 101C",
            "city": "JOHNSON CITY",
            "state": "TX",
            "postal_code": "786364950",
            "telephone_number": "830-868-7800",
            "fax_number": "830-992-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JOHN",
        "middle_name": "DUDLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G8495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133026802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TX

Sources for this page

Verify at the official NPI Registry.