NPIMap

Individual provider Active NPI

Jack Eugene Weaver, MD

  • Interventional Pain Medicine Physician
  • Muskogee, OK
National Provider Identifier
1902802101
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
19721 Issued in OK
Practice address
209 S 36TH St
Muskogee, OK 74401-5043
Phone
(918) 710-4112
Fax
(918) 710-4118
NPI assigned
Jun 22, 2005
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19721 OK
Family Medicine Physician 207Q00000X 19721 OK
Interventional Pain Medicine Physician 208VP0014X 19721 OK Primary

Addresses

Primary practice location

209 S 36TH St
Muskogee, OK 74401-5043

Mailing address

4750 S Garnett Rd
Tulsa, OK 74146-5222
Phone (918) 710-4112

Other identifiers 2

IdentifierTypeStateIssuer
1841508918OtherOKGROUP NPI
100088830AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20111020000143 OK Practitioner - Interventional Pain ManagementPractitioner - Sports Medicine 4486543865 Reassigns benefits to 2 organizations
I20220412001224 TX Practitioner - Family Practice 4486543865 Reassigns benefits to 1 organization
O20100930098570 OK DME Supplier - Physician - Family PracticeDME Supplier - Sports Medicine 6901096239 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Muskogee, OK

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Sports Medicine
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Pain SolutionsGroup PAC ID 2668620220, 13 clinicians
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

209 S 36TH St
Muskogee, OK 74401-5043
Phone (918) 682-7717

27371 S 4410 Rd
Vinita, OK 74301-7953
Phone (918) 256-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19721OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Feb 25, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Access Pain Solutions CurrentSince Nov 1, 2025 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Jack E Weaver, MD PC Family Medicine CurrentSince Oct 2, 2011 Accepting new patients
Cherokee Nation CurrentSince Feb 25, 2022 Accepting new patients
Northeastern Health System Interventional Pain Medicine Past Accepting new patients
Saint Francis Hospital Muskogee Inc Interventional Pain Medicine Past Accepting new patients
Muskogee Bone & Joint & Sports Medicine Specialist Past Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

209 S 36th St
Muskogee, OK 74401
Phone (918) 682-7717

3401 W Broadway St
Muskogee, OK 74401
Phone (918) 687-5477

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

3905 S Highway 97
Sand Springs, OK 74063
Phone (918) 245-7500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

4750 S Garnett Rd
Tulsa, OK 74146
Phone (539) 812-2100

7901 S Sheridan Rd
Tulsa, OK 74133
Phone (918) 492-0412

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/
  • Direct secure messaging: jack.weaver@1345.chartlogic.direct-ci.com

Organizations & group practices 11

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 9

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1902802101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 S GARNETT RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465222",
            "telephone_number": "918-710-4112",
            "fax_number": "918-710-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S 36TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015043",
            "telephone_number": "918-710-4112",
            "fax_number": "918-710-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JACK",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "19721",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "19721",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "19721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1841508918",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088830A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.