Active NPI
Mary J Weir, PA-C
- Medical Physician Assistant
- Weatherford, TX
National Provider Identifier
1861689200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA14826
- Practice address
- 150 Willow Creek Dr Ste 103
Weatherford, TX 76085-3652 - Phone
- (817) 599-6387
- Fax
- (817) 599-6378
- NPI assigned
- Oct 1, 2007
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA17711 | CA | |
| Medical Physician Assistant | 363AM0700X | PA14826 | TX | Primary |
Addresses
Primary practice location
150 Willow Creek Dr Ste 103
Weatherford, TX 76085-3652
Mailing address
150 Willow Creek Dr Ste 103
Weatherford, TX 76085-3652
Phone (817) 599-6387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210816000019 | TX | Practitioner - Physician Assistant | 4688627235 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brazos Regional Neurology, PA | Current | Accepting new patients | |
| Weatherford Health Services, LLC | Past | Accepting new patients | |
| Riverside Healthcare System, L.P. | Past | Accepting new patients | |
| Doctors Hospital of Riverside LLC | Past | Accepting new patients |
Locations
150 Willow Creek Dr
Ste 103
Weatherford, TX 76085
Phone (817) 550-6115
1212 Clear Lake Rd
Ste 300
Weatherford, TX 76086
Phone (817) 599-6387
Interoperability endpoints
- https://api.platform.athenahealth.com/2626/brand/1/csg/1/fhir/r4
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 and National Provider Directory roles.
-
- Neurology Physician
- Weatherford, TX
- NPI 1952616005
-
- General Acute Care Hospital
- Weatherford, TX
- NPI 1417471467
-
- General Acute Care Hospital
- Riverside, CA
- NPI 1124596382
-
- Rehabilitation Hospital Unit
- Riverside, CA
- NPI 1053358010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633305600000",
"number": "1861689200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 WILLOW CREEK DR STE 103",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760853652",
"telephone_number": "817-599-6387",
"fax_number": "817-599-6378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 WILLOW CREEK DR STE 103",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760853652",
"telephone_number": "817-599-6387",
"fax_number": "817-599-6378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIR",
"first_name": "MARY",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-01",
"last_updated": "2021-10-04",
"certification_date": "2021-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA17711",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA14826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.