CARLY JEAN WEAVER (NPI# 1629637293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629637293 |
| Entity Type | Individual |
| Full Name | CARLY JEAN WEAVER |
| Practice Address |
12470 Telecom Dr Ste 300w Temple Terrace FL 33637-0904 |
| Practice Telephone | 8138718200 |
| Practice Fax Number | 8133575501 |
| Mailing Telephone | 8138718183 |
| Mailing Fax Number | 8138718184 |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APRN11001578 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
11001578 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DEPARTMENT OF HEALTH | APRN11001578 | 01 |
| DEA | MW5290630 | 01 | |
| FL | BLUE CROSS BLUE SHIELD | 4ULEI | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3003 W Dr Martin Luther King Jr Blvd, Tampa, FL 336076307 | 8138718200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326304692 | Carly E Weaver | Occupational Therapist | 7 Carnegie Plz, Cherry Hill, NJ 08003-1000 | 2012-04-11 |
| Street Address |
12470 TELECOM DR STE 300W |
| City | TEMPLE TERRACE |
| State | FL |
| Zip Code | 33637-0904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942297676 | Radu Mercea | Family Medicine | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2005-09-27 |
| 1265076053 | Mallory Quinette | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2019-11-05 |
| 1811553480 | Mandaly Claude Louis-charles | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2019-05-19 |
| 1154887362 | Ruth Joan Peloton Ragoro | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2019-02-12 |
| 1629581426 | Mrudula N Patel | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2017-11-15 |
| 1073033676 | Sally Ann Robertson | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2017-06-23 |
| 1710428602 | Jessica Bailes | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637 | 2017-03-13 |
| 1144679176 | Maribeth Allen | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2016-06-09 |
| 1225492416 | Seon Wook Lee | Family Medicine | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2016-04-13 |
| 1225412463 | Beverly Joan Gilbert | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2015-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023677846 | Ivory Jewels Hha LLC | Home Health | 7320 E. Fletcher Ave Suite 127, Tampa, FL 33637 | 2019-06-06 |
| 1346753134 | Mental Fitness Group, LLC | Clinic/Center | 8875 Hidden River Pkwy Ste 300, Tampa, FL 33637 | 2017-11-15 |
| 1669854857 | Tatessica Cooley | Counselor | 7403 Temple Terrace Highway, Suite B, Tampa, FL 33637 | 2015-06-24 |
| 1336526854 | Lisa Magliarditi | Physical Therapist | 12110 Morris Brige Road, 3rd Floor Therapy Suite, Tampa, FL 33637 | 2015-05-05 |
| 1225472277 | Amber Kuzma | Behavioral Analyst | 7025 Ponderosa Dr, Tampa, FL 33637 | 2013-04-22 |
| 1326315516 | Christopher L. Leitten | Psychologist | 9710 Woodland Ridge Dr., Tampa, FL 33637 | 2011-11-16 |
| 1669765178 | Christina Sara Philip | Internal Medicine | 12470 Telecom Drive, Ste 300w, Temple Terrace, FL 33637 | 2011-05-17 |
| 1912129800 | Alison Brothers | Speech-Language Pathologist | 8800 Grand Oak Circle, Suite 450, Tampa, FL 33637 | 2007-05-02 |
| 1427187020 | Nauman A. Siddiqi | Internal Medicine | 7523 Terrace River Drive, Temple Terrace, FL 33637 | 2007-03-02 |
| 1205945243 | Florida Orthopaedic Institute Surgery Center LLC | Clinic/Center | 13060 Telecom Parkway, Temple Terrace, FL 33637 | 2006-08-30 |
| Find all providers in zip 33637 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497093165 | Erika Hall | Nurse Practitioner | 5470 E Busch Blvd Ste 461, Temple Terrace, FL 33617-5418 | 2013-01-30 |
| 1538312780 | Lawanda Nadine Goehring | Nurse Practitioner | 820 Druid Hills Rd, Temple Terrace, FL 33617-3812 | 2008-11-01 |
| 1366570525 | Christine E Patrick | Nurse Practitioner | 10801 N 56th St, Temple Terrace, FL 33617-3646 | 2007-03-01 |
| 1275575938 | Teresa Dessert Barfield | Nurse Practitioner | 11150 N 53rd St, Temple Terrace, FL 33617-4068 | 2006-06-10 |
| 1447899224 | Nakita Lagadere | Nurse Practitioner | 12470 Telecom Dr Ste 100, Temple Terrace, FL 33637-0904 | 2019-12-27 |
| 1265076053 | Mallory Quinette | Nurse Practitioner | 12470 Telecom Dr Ste 300w, Temple Terrace, FL 33637-0904 | 2019-11-05 |
| 1811538440 | Jennilee Lauran Pino | Nurse Practitioner | 12470 Telecom Dr Ste 100, Temple Terrace, FL 33637-0904 | 2019-10-04 |
| 1265990022 | Sandra Pizzurro | Nurse Practitioner | 13020 N Telecom Pkwy, Temple Terrace, FL 33637-0925 | 2019-03-11 |
| 1245703826 | Saramma Thomas | Nurse Practitioner | 13067 N Telecom Pkwy, Temple Terrace, FL 33637-0926 | 2019-01-07 |
| 1124529193 | Cynthia Leo | Nurse Practitioner | 13067 Telecom Parkway N, Temple Terrace, FL 33637 | 2018-02-26 |
| Find all providers in TEMPLE TERRACE | ||||
| City | TEMPLE TERRACE |
| Zip Code | 33637 |
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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.