MR. JACK WEAVER JR. (NPI# 1184055048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184055048 |
| Entity Type | Individual |
| Full Name | MR. JACK WEAVER JR. |
| Credential | ALC |
| Practice Address |
521 Gault Ave N Fort Payne AL 35967-2307 |
| Practice Telephone | 2562737216 |
| Mailing Telephone | 2562737216 |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
C2207A | AL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043238389 | Jack H Weaver | Dentist | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2006-07-17 |
| 1558342154 | Jack David Weaver | Chiropractor | 3051 Victor Ave, Redding, CA 96002-1450 | 2005-11-10 |
| 1902802101 | Jack Eugene Weaver | Specialist | 209 S 36th St, Muskogee, OK 74401-5043 | 2005-06-22 |
| Street Address |
521 GAULT AVE N |
| City | FORT PAYNE |
| State | AL |
| Zip Code | 35967-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942688601 | Don G. Brock | Counselor | 521 Gault Ave N, Fort Payne, AL 35967-2307 | 2015-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073086922 | Ft Payne Careplus, LLC | Clinic/Center | 3000 Gault Ave North, Ft Payne, AL 35967 | 2019-01-03 |
| 1851739023 | Marlon Chad Williamson | Emergency Medicine | 617 Gault Ave N, Fort Payne, AL 35967 | 2013-06-11 |
| 1447552401 | Karole Kelley Ohme | Counselor | 216 Gault Avenue N, Relationship Clinic, Fort Payne, AL 35967 | 2010-11-24 |
| 1720112014 | Dekalb County Mr Board | Case Management | 117 First St Nw, Fort Payne, AL 35967 | 2007-03-16 |
| 1447275490 | Glynn Whiddon Odom | Nurse Anesthetist, Certified Registered | 200 Medical Center Drive, Fort Payne, AL 35967 | 2006-07-12 |
| 1477521698 | Michael Ray Parker | Optometrist | 900 Gault Ave S, Fort Payne, AL 35967 | 2006-03-14 |
| 1144204843 | Dale Ray Stierwalt | Family Medicine | 1618 Gault Ave. N., Fort Payne, AL 35967 | 2005-12-06 |
| 1417951112 | Barton Drake Ibsen | Physical Therapist | 121 Drinkard Dr, Fort Payne, AL 35967 | 2005-06-09 |
| 1407363146 | Tyson Scott Rainer | Nurse Practitioner | 1040 Glenn Blvd Sw, Fort Payne, AL 35967 | 2018-01-03 |
| 1801336599 | Caitlin Kirby | Massage Therapist | 216 Gault Ave N, Fort Payne, AL 35967 | 2017-03-01 |
| Find all providers in zip 35967 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630134 | Limestone Behavioral Health Services, Inc | Counselor | 204 Alabama Ave Sw, Fort Payne, AL 35967-1953 | 2020-05-12 |
| 1649803073 | Little River Counseling | Counselor | 207 Gault Ave S Ste B, Fort Payne, AL 35967-1902 | 2020-02-13 |
| 1104329259 | Ida Rose Millican | Counselor | 206 4th St Sw, Fort Payne, AL 35967-1851 | 2018-03-15 |
| 1942631817 | Synergy Ministries, Inc. | Counselor | 701b Gault Ave N, Fort Payne, AL 35967-2627 | 2013-12-03 |
| 1447552401 | Karole Kelley Ohme | Counselor | 216 Gault Avenue N, Relationship Clinic, Fort Payne, AL 35967 | 2010-11-24 |
| 1942688601 | Don G. Brock | Counselor | 521 Gault Ave N, Fort Payne, AL 35967-2307 | 2015-05-14 |
| 1669746384 | Rachel Alanna Lewis-brisendine | Counselor | 301 Godfrey Ave Se, Fort Payne, AL 35967-1825 | 2012-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506874 | Leah Chapman Braue | Counselor | 3420 Fairway Dr, Trussville, AL 35173-5122 | 2020-10-21 |
| 1447859368 | Luther Graham Bufford | Counselor | 119 Shades Crest Rd, Hoover, AL 35226-1011 | 2020-10-21 |
| 1396344602 | H.o.p.e. Counseling and Consulting, LLC | Counselor | 820 S. University Blvd Ste. 4-f, Mobile, AL 36609-3660 | 2020-10-19 |
| 1437758802 | Cori C Ray | Counselor | 1025 Montgomery Hwy Ste 210, Vestavia Hills, AL 35216-2830 | 2020-10-18 |
| 1871191262 | Leslie N Weaver | Counselor | 656 Townsend Circle, Chickasaw, Alabama, AL 36611 | 2020-10-16 |
| 1134727266 | Jessica Lea Hawken | Counselor | 202 Britt Dr, Enterprise, AL 36330-7882 | 2020-10-12 |
| 1225635196 | Angel's Pond Counseling | Counselor | 208 Searcy St, Enterprise, AL 36330-2739 | 2020-10-05 |
| 1144827031 | Marable Counseling & Consulting Services, LLC | Counselor | 400 Century Park S Ste 106, Birmingham, AL 35226-3925 | 2020-10-05 |
| 1023624590 | Lovett Counseling LLC | Counselor | 1025 Montgomery Hwy Ste 208, Vestavia Hills, AL 35216-2830 | 2020-09-21 |
| 1841806585 | Elaine K Young | Counselor | 674 Provence Drive, Vestavia, AL 35242-2288 | 2020-09-18 |
| Find all providers with the same taxonomy | ||||
| City | FORT PAYNE |
| Zip Code | 35967 |
Please comment or provide details below to improve the information on MR. JACK WEAVER JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.