Active NPI
Richard J Weaver, DC
- Chiropractor
- Bangor, PA
National Provider Identifier
1912911371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC007215L
- Practice address
- 83 Bangor Junction Road
Blue Valley Plaza
Bangor, PA 18013 - Phone
- (610) 588-7640
- Fax
- (610) 588-7114
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC007215L | PA | Primary |
Addresses
Primary practice location
83 Bangor Junction Road
Blue Valley Plaza
Bangor, PA 18013
Mailing address
331 S Broad St
Nazareth, PA 18064
Phone (610) 393-1440
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02783600 | Other | PA | CAPITAL BC |
| 2215248 | Other | PA | AETNA |
| 557504 | Other | PA | BLUE SHIELD |
| 768867 | Other | PA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
83 Bangor Junction Rd
Bangor, PA 18013-9314
Phone (610) 588-7640
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC007215L | PA | MD | Chiropractor |
Organizations & group practices 1
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.
-
- Chiropractor
- Bangor, PA
- NPI 1205160694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912911371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 S BROAD ST",
"city": "NAZARETH",
"state": "PA",
"postal_code": "18064",
"telephone_number": "610-393-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 BANGOR JUNCTION ROAD",
"address_2": "BLUE VALLEY PLAZA",
"city": "BANGOR",
"state": "PA",
"postal_code": "18013",
"telephone_number": "610-588-7640",
"fax_number": "610-588-7114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "RICHARD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC007215L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BC",
"identifier": "02783600",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2215248",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "557504",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "768867",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bangor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.