Individual provider Active NPI

Corey R Weaver, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clive, IA
National Provider Identifier
1922586361
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G104242 Issued in IA
Practice address
9550 Hickman Rd Ste 101
Clive, IA 50325-5314
Phone
(515) 758-8300
Fax
(515) 758-8600
NPI assigned
Jul 28, 2018
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G104242 IA Primary

Addresses

Primary practice location

9550 Hickman Rd Ste 101
Clive, IA 50325-5314

Mailing address

9550 Hickman Rd Ste 101
Clive, IA 50325-5314
Phone (515) 758-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20180913001714 IA Practitioner - Nurse Practitioner 1759631674 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.61 of 100Reported as group
Quality
75.16
Promoting interoperability
100
Improvement activities
40
Cost
76.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G104242IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Aug 27, 2018 Accepting new patients
Adair County Memorial Hospital CurrentSince Mar 1, 2025 Accepting new patients
Adair County Memorial Hospital CurrentSince Mar 1, 2025 Accepting new patients
Broadlawns Medical Center CurrentSince Aug 27, 2018 Accepting new patients
Adair County Memorial Hospital Current Accepting new patients
Adair County Memorial Hospital Past Accepting new patients
Integrated Psychiatry PLLC PastSince Dec 21, 2025 Accepting new patients

Locations

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

609 SE Kent St
Greenfield, IA 50849
Phone (641) 743-2123

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f904b187-16a4-4582-8ea3-887d87de0011/
  • Direct secure messaging: weaver.corey@cynchealthdsm.org

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1922586361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 HICKMAN RD STE 101",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503255314",
            "telephone_number": "515-758-8300",
            "fax_number": "515-758-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 HICKMAN RD STE 101",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503255314",
            "telephone_number": "515-758-8300",
            "fax_number": "515-758-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "COREY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-28",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G104242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.