DR. MELODY ANN WEAVER (NPI# 1922204551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922204551 |
| Entity Type | Individual |
| Full Name | DR. MELODY ANN WEAVER |
| Credential | PHD FNP |
| Practice Address |
921 S 8th Ave Stop 8101 Pocatello ID 83209 |
| Mailing Address |
921 S 8th Ave Stop 8101 Pocatello ID 83209-0001 |
| Practice Telephone | 2082825994 |
| Practice Fax Number | 2082824476 |
| Mailing Telephone | 2082825994 |
| Mailing Fax Number | 2082824476 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2018-06-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
55023 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP10764 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
921 S 8TH AVE STOP 8101 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093097081 | Eydie Kendall | Physical Therapist | 1400 Terry Drive, Pocatello, ID 83209 | 2011-09-15 |
| 1548548589 | Corrie Elizabeth Holmes | Audiologist | 650 Memorial Drive Building 68, Pocatello, ID 83209 | 2011-07-25 |
| 1730351081 | Idaho State University | Pharmacy | 990 South 8th, Pocatello, ID 83209 | 2008-03-27 |
| 1710482500 | Ashley Letson | Specialist/Technologist | 921 S 8th Ave, Mcintosh Manor D9, Pocatello, ID 83209 | 2018-03-26 |
| 1407261407 | Stephen B Grandy | Dentist | 465 Memorial Drive, Pocatello, ID 83209-0000 | 2014-06-27 |
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1174149389 | Santiago A Segura Barron | Specialist/Technologist | Holt Arena 550 Memorial Drive Building 50, Pocatello, ID 83209-0001 | 2020-06-23 |
| 1639658248 | Luis Rodriguez | Psychologist | 1400 Eas Terry Dr Bldg 63 Garrison Hall 5th Floor, Pocatello, ID 83209-0001 | 2018-08-14 |
| 1205384484 | Max Esposito | Physical Medicine & Rehabilitation | 1400 E Terry Dr, Pocatello, ID 83209-0001 | 2016-09-15 |
| 1306022041 | Kelly Elizabeth Thompson | Occupational Therapist | Department of Physical and Occupational Therapy, Mail Stop 8045, Pocatello, ID 83209-0001 | 2008-01-11 |
| Find all providers in zip 83209 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679183388 | Health Innovations, LLC | Nurse Practitioner | 240 N 18th Ave, Pocatello, ID 83201-3324 | 2020-08-06 |
| 1285295634 | Rebekah Lucero | Nurse Practitioner | 2185 Steven St, Pocatello, ID 83201-1928 | 2019-06-26 |
| 1285199869 | Jason Knighton | Nurse Practitioner | 5800 S 5th Ave, Pocatello, ID 83204-2205 | 2019-02-07 |
| 1356812945 | Dellisa Dawn Eddington | Nurse Practitioner | 6000 S 5th Ave, Pocatello, ID 83204-5075 | 2018-12-08 |
| 1457839730 | In Balance: Integrative Primary Healthcare Pllc | Nurse Practitioner | 1017 E Young St, Pocatello, ID 83201-5237 | 2018-07-30 |
| 1851885420 | Jordan Clay Chapman | Nurse Practitioner | 777 Hospital Way Ofc Bldg, Pocatello, ID 83201-2797 | 2018-06-18 |
| 1356846398 | Paul Haislip | Nurse Practitioner | 340 N 14th Ave, Pocatello, ID 83201-4118 | 2018-03-29 |
| 1568906865 | Dustin Reno | Nurse Practitioner | 1155 Yellowstone Ave Ste D, Pocatello, ID 83201-4369 | 2016-12-06 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1376992503 | Andrea Walsh | Nurse Practitioner | 1133 Call Creek Dr, Ste A, Pocatello, ID 83202 | 2016-06-08 |
| Find all providers in POCATELLO | ||||
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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.