PHILLIP ALEXANDER WEAVER (NPI# 1962062620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962062620 |
| Entity Type | Individual |
| Full Name | PHILLIP ALEXANDER WEAVER |
| Credential | PA-S |
| Practice Address |
100 Church St S Ste A230 New Haven CT 06519-1703 |
| Practice Telephone | 2037372099 |
| Enumeration Date | 2019-06-15 |
| Last Update Date | 2019-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386749158 | Phillip Duane Weaver | Pharmacist | 2802 Valley Brook Dr, Champaign, IL 61822-7621 | 2006-09-14 |
| 1811337272 | Phillip Russ Weaver | Nurse Practitioner | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2013-07-01 |
| Street Address |
100 CHURCH ST S STE A230 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528685260 | Amanda Amster | Physician Assistant | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2020-06-29 |
| 1003439142 | Angela Wei | Student in an Organized Health Care Education/Training Program | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2020-05-23 |
| 1629697594 | Rebecca Dronet | Student in an Organized Health Care Education/Training Program | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2020-04-10 |
| 1487285763 | Sandra Christine-bozik Lyman | Student in an Organized Health Care Education/Training Program | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2020-01-27 |
| 1437798154 | Dustin Vuong | Student in an Organized Health Care Education/Training Program | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2019-12-28 |
| 1811536600 | Mary Ruggeri | Student in an Organized Health Care Education/Training Program | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2019-12-27 |
| 1194377267 | Rebecca Preston | Student in an Organized Health Care Education/Training Program | 100 Church St S Ste A230, New Haven, CT 06519-1703 | 2019-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
| 1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| 1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
| 1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
| 1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
| 1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
| 1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
| Find all providers in zip 06519 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019689 | Mallori Wisuri | Student in an Organized Health Care Education/Training Program | 14505 Old 24 E, New Haven, IN 46774-9013 | 2020-06-27 |
| 1952920019 | Nazli Dizman | Student in an Organized Health Care Education/Training Program | 20 York St Tompkins 226, New Haven, CT 06510-3220 | 2020-04-09 |
| 1972132314 | Ross David Logan | Student in an Organized Health Care Education/Training Program | 20 York St Ste 226, New Haven, CT 06510-3220 | 2020-04-07 |
| 1194354043 | Christian Keene | Student in an Organized Health Care Education/Training Program | 625 Orange St Apt 43, New Haven, CT 06511-3840 | 2020-04-03 |
| 1639706146 | Kevin Jiang | Student in an Organized Health Care Education/Training Program | 330 Orchard St Ste 207, New Haven, CT 06511-4429 | 2020-03-25 |
| 1144855263 | Daniel Jacobs | Student in an Organized Health Care Education/Training Program | 367 Cedar Street, Bldg. D, Student Affairs Office, New Haven, CT 06510 | 2020-03-09 |
| 1275166407 | Joshua Braden | Student in an Organized Health Care Education/Training Program | 32277 Salt River Cir N, New Haven, MI 48048-3331 | 2020-02-17 |
| 1871125401 | Taylor Alexandra Babin | Student in an Organized Health Care Education/Training Program | 166 Hall St, New Haven, CT 06512-3148 | 2020-02-11 |
| 1952962649 | Su Jung Kim | Student in an Organized Health Care Education/Training Program | 111 Park St Apt 12t, New Haven, CT 06511-5421 | 2019-06-24 |
| 1144880691 | Durga Thakral | Student in an Organized Health Care Education/Training Program | 367 Cedar St Ste 317, New Haven, CT 06510-3222 | 2019-06-17 |
| Find all providers in NEW HAVEN | ||||
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| 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.