DR. MALLORY WEAVER DO
NPI 1376235861
Family Medicine in Peoria, IL
About Dr. Mallory Weaver Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MALLORY WEAVER DO (NPI 1376235861) is an individual family medicine provider in Peoria, Illinois, licensed in Illinois (036179363) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS, is affiliated with Methodist Medical Center Of Illinois, and is a graduate of At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa (2023).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Mallory Weaver Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Methodist Medical Center Of Illinois
Acute Care Hospitals · Peoria, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 61602 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PEORIA, IL 61602
PEORIA, IL 61602
PEORIA, IL 61602
PEORIA, IL 61602
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mallory Weaver's NPI number?
The NPI number for Mallory Weaver is 1376235861. It was assigned to this individual provider in the NPPES registry on May 23, 2023.
Where is Mallory Weaver located?
Mallory Weaver practices at 815 Main St Ste C, Peoria, IL 61602. The listed phone number is (309) 672-4977.
What is Mallory Weaver's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mallory Weaver enrolled in Medicare?
Yes. Mallory Weaver is registered in the Medicare PECOS enrollment system.
Is Mallory Weaver affiliated with any hospitals?
According to CMS data, Mallory Weaver is affiliated with Methodist Medical Center Of Illinois.
When was this NPI record last updated?
The NPPES record for Mallory Weaver was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Mallory Weaver, DO · NPI 1376235861
Family Medicine physician in Peoria, Illinois. Individual provider, active in the CMS NPPES registry since May 23, 2023.
## Identity
- **NPI:** 1376235861 (Entity type: Individual)
- **Enumerated:** May 23, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 036179363 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 815 MAIN ST STE C, Peoria, IL 61602-1080
- **Phone:** (309) 672-4977
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa, class of 2023
## Record status
- **NPPES last updated:** August 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1376235861) · Data from the CMS NPPES public registry.