Individual provider Active NPI

Krista Ray Weaver

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1992544639
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103600 Issued in TX
Practice address
13612 Midway Rd Ste 605
Dallas, TX 75244-4324
Phone
(214) 530-0021
Fax
(214) 530-0021
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 103600 TX Primary

Addresses

Primary practice location

13612 Midway Rd Ste 605
Dallas, TX 75244-4324

Mailing address

8150 N Central Expy Ste 1625
Dallas, TX 75206-1806
Phone (214) 530-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241107000157 TX Practitioner - Clinical Social Worker 1951835412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taylor Counseling GroupGroup PAC ID 7012360019, 36 clinicians

Practice addresses (Care Compare)

13612 Midway Rd
Suite 605
Farmers Branch, TX 75244-4324
Phone 21453000210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103600TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Counseling Group CurrentSince Aug 24, 2024 Accepting new patients

Locations

8150 N Central Expy
Ste 1625
Dallas, TX 75206
Phone 97957437170

13612 Midway Rd
Ste 605
Farmers Branch, TX 75244

101 Summit Ave
Ste 204
Fort Worth, TX 76102

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.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1992544639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 N CENTRAL EXPY STE 1625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061806",
            "telephone_number": "214-530-0021",
            "fax_number": "214-530-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13612 MIDWAY RD STE 605",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752444324",
            "telephone_number": "214-530-0021",
            "fax_number": "214-530-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KRISTA",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "103600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.