Active NPI
Allayne E Weaver, DPT
- Physical Therapist
- Waterloo, IL
National Provider Identifier
1942596911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.018483
- Practice address
- 509 Hamacher St
Ste 101
Waterloo, IL 62298-1592 - Phone
- (618) 939-5555
- NPI assigned
- Jun 28, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 070.018483 | IL | Primary |
Addresses
Primary practice location
509 Hamacher St
Ste 101
Waterloo, IL 62298-1592
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01425606 | Other | MO | RR MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | AWEAVER605178@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.018483 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah | Current | Accepting new patients | |
| University of Utah | Current | Accepting new patients | |
| FLS Physical Therapy Associates PC | Physical Therapist | Past | Accepting new patients |
Locations
127 S 500 E
Ste 400
Salt Lake City, UT 84102
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- aweaver605178@direct.med.utah.edu
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.
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
-
- Physical Therapy Clinic/Center
- Columbia, IL
- NPI 1669432522
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733616000000",
"number": "1942596911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 HAMACHER ST",
"address_2": "STE 101",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622981592",
"telephone_number": "618-939-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "ALLAYNE",
"middle_name": "E",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-28",
"last_updated": "2024-12-08",
"certification_date": "2024-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.018483",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01425606",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "AWEAVER605178@DIRECT.MED.UTAH.EDU",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Waterloo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.