Individual provider Active NPI

Amy Johnanna Weaver, ANP-C

  • Adult Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1891715025
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
584684 Issued in TX
Practice address
17376 Northwest Fwy
Houston, TX 77040-1114
Phone
(713) 466-0197
Fax
(713) 477-0375
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 584684 TX Primary

Addresses

Primary practice location

17376 Northwest Fwy
Houston, TX 77040-1114

Mailing address

600 Whiteoak Dr
Lumberton, TX 77657-7133
Phone (409) 751-4647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20061121000624 TX Practitioner - Nurse Practitioner 0749288074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

21820 Katy Fwy
Suite 200
Katy, TX 77449-7901
Phone (346) 396-2451

Hospital & facility affiliations

  • HCA Houston Healthcare Tomball Hospital, Tomball, TX, CCN 450670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
584684TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Practice, L.L.P CurrentSince Mar 27, 2020 Accepting new patients
Villagemd of Southeast Texas, PA CurrentSince Mar 27, 2020 Accepting new patients
NPI 1851569339 Past Accepting new patients
Gulf Coast Health Center, Inc Past Accepting new patients

Locations

9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954

17347 Village Green Dr
Ste 106
Jersey Village, TX 77040
Phone (713) 466-0197

21820 Katy Fwy
Ste 200
Katy, TX 77449
Phone (346) 396-2451

155 School St
Ste 300
Tomball, TX 77375
Phone (281) 255-3838

Interoperability endpoints

  • Direct secure messaging: amy.weaver.1@13711.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1891715025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WHITEOAK DR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776577133",
            "telephone_number": "409-751-4647",
            "fax_number": "409-751-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17376 NORTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770401114",
            "telephone_number": "713-466-0197",
            "fax_number": "713-477-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "AMY",
        "middle_name": "JOHNANNA",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "584684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.