Active NPI
Rose Ann Weaver, MD
- Internal Medicine Physician
- Madison, GA
National Provider Identifier
1922100361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 13701
- Practice address
- 172 North Main St
Madison, GA 30650 - Phone
- (706) 342-4106
- Fax
- (706) 343-0046
- NPI assigned
- Sep 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 13701 | GA | Primary |
Addresses
Primary practice location
172 North Main St
Madison, GA 30650
Mailing address
172 North Main St
Madison, GA 30650
Phone (706) 342-4106
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00024032A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13701 | GA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269475200000",
"number": "1922100361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 NORTH MAIN ST",
"city": "MADISON",
"state": "GA",
"postal_code": "30650",
"telephone_number": "706-342-4106",
"fax_number": "706-343-0046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 NORTH MAIN ST",
"city": "MADISON",
"state": "GA",
"postal_code": "30650",
"telephone_number": "706-342-4106",
"fax_number": "706-343-0046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "ROSE ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2010-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "13701",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00024032A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.