DEREK WEAVER (NPI# 1003267808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003267808 |
| Entity Type | Individual |
| Full Name | DEREK WEAVER |
| Practice Address |
1128 Nw Harriman St Bend OR 97703-1947 |
| Mailing Address |
2577 Ne Courtney Dr Bend OR 97701-7638 |
| Practice Telephone | 5413304638 |
| Practice Fax Number | 5413304630 |
| Mailing Telephone | 5413227500 |
| Mailing Fax Number | 5413227565 |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962660704 | Derek Samuel Weaver | Family Medicine | 2935 Allen Rd, Sunnyside, WA 98944-8931 | 2008-05-29 |
| Street Address |
1128 NW HARRIMAN ST |
| City | BEND |
| State | OR |
| Zip Code | 97703-1947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578582631 | Tina Marie Busby | Family Medicine | 1128 Nw Harriman St, Bend, OR 97701-1947 | 2006-07-19 |
| 1891309803 | Alexi Jo Rogers | Peer Specialist | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2020-09-07 |
| 1922649490 | Jennifer Kay Laurie | Peer Specialist | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2019-10-04 |
| 1265081343 | Jennifer L Mendez | Peer Specialist | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2019-09-10 |
| 1265086110 | Kathleen Ann De Vito | Case Manager/Care Coordinator | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2019-07-29 |
| 1053973719 | Leah Marie Lewis | Counselor | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2019-07-02 |
| 1134787609 | Molly Sue Wells Darling | Social Worker | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2019-05-30 |
| 1225692486 | Melissa W Carneiro | Case Manager/Care Coordinator | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2019-04-23 |
| 1295216604 | Rachel Arbetter | Case Manager/Care Coordinator | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2018-08-23 |
| 1114407822 | Joshua James Gage | Case Manager/Care Coordinator | 1128 Nw Harriman St, Bend, OR 97703-1947 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250704 | Elizabeth Jane Lindt | Counselor | 63311 Jamison Street, Bend, OR 97703 | 2020-06-20 |
| 1790318145 | Leah Alice Williamson | Counselor | 118 Nw Thurston Ave, Bend, OR 97703 | 2020-02-13 |
| 1831658301 | Pretty Moments Lingerie, LLC | Durable Medical Equipment & Medical Supplies | 63455 N Hwy 97 Suite 44, Bend, OR 97703 | 2019-03-14 |
| 1821561150 | Kevin Hallmeyer | Chiropractor | 750 Nw Charbonneau St., Suite 101, Bend, OR 97703 | 2019-01-09 |
| 1346743267 | Jesse Maggie Mae Abraham | Massage Therapist | 39 Nw Lousiana Ave, Bend, OR 97703 | 2018-03-16 |
| 1891202396 | Jerod Paul Michael | Speech-Language Pathologist | 2736 Nw Crossing Dr, Ste. 120, Bend, OR 97703 | 2018-01-05 |
| 1952823023 | Dan Packman | Massage Therapist | 2955 N. Hwy 97, Ste 105, Riverside Wellness, Voila Massage, Bend, OR 97703 | 2017-07-11 |
| 1023460102 | Brennon Patrick Moore | Counselor | 835 Nw Bond St Ste 100, Bend, OR 97703 | 2016-07-12 |
| 1093160269 | Eric Hinds | Optometrist | 63455 N Highway 97 Ste 75, Bend, OR 97703 | 2016-04-25 |
| 1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
| Find all providers in zip 97703 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162145 | Kenneth Branson | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-10-23 |
| 1679188080 | Michelle Marie Bunkers | Peer Specialist | 20517 Jacklight Ln, Bend, OR 97702-2971 | 2020-09-11 |
| 1922585413 | Daniel Tovar | Peer Specialist | 1435 Ne 4th St Ste B, Bend, OR 97701-4268 | 2018-07-26 |
| 1194190652 | Breann M Flores | Peer Specialist | 1435 Ne 4th St Suite B, Bend, OR 97701 | 2015-12-09 |
| 1144821745 | Kristi L Schaffner | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-11-02 |
| 1760083356 | Farrah Suzanne Carkhuff | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-11-02 |
| 1982201737 | Kristie Galarza | Peer Specialist | 908 Ne 4th St Ste 101, Bend, OR 97701-4646 | 2020-10-05 |
| 1740887561 | Nickolas Petragallo | Peer Specialist | 908 Ne 4th St Ste 101, Bend, OR 97701-4646 | 2020-10-05 |
| 1922614130 | Kellie Rae Seems | Peer Specialist | 1435 Ne 4th St Ste B, Bend, OR 97701-4268 | 2020-09-22 |
| 1124633532 | Travis M Nelson | Peer Specialist | 1435 Ne 4th St Ste B, Bend, OR 97701-4268 | 2020-09-11 |
| Find all providers in BEND | ||||
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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.