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TARA ANN WEAVER
NPI 1609736453
Physician Assistant - Medical in Columbia, SC

Active since November 14, 2025PECOS Enrolled
1600 LAKE MURRAY BLVD, COLUMBIA, SC 29212(803) 731-9600 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Tara Ann Weaver NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA ANN WEAVER (NPI 1609736453) is an individual medical provider in Columbia, South Carolina, licensed in South Carolina (6140) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1609736453
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTARA ANN WEAVER
Location Address1600 LAKE MURRAY BLVDColumbia, SC 29212-8623
Mailing Address117 White Birch CtLexington, SC 29073-6905
Phone(803) 731-9600
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 14, 2025
NPPES CertifiedNovember 14, 2025
✔ NPI 1609736453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in SC · 6140
1600 LAKE MURRAY BLVD, Columbia, SC 29212
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tara Ann Weaver is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456834746
PECOS Enrollment IDI20260315000165
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. COTY L CAMPBELL N.P.
Nurse Practitioner (Family)
1600 LAKE MURRAY BLVD
COLUMBIA, SC 29212
Lexington County (803) 731-9600
DR. JESSICA R BURGY MD
Dermatology
1600 LAKE MURRAY BLVD
COLUMBIA, SC 29212
Lexington County (803) 731-9600

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 Tara Weaver's NPI number?

The NPI number for Tara Weaver is 1609736453. It was assigned to this individual provider in the NPPES registry on November 14, 2025.

Where is Tara Weaver located?

Tara Weaver practices at 1600 Lake Murray Blvd, Columbia, SC 29212. The listed phone number is (803) 731-9600.

What is Tara Weaver's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tara Weaver enrolled in Medicare?

Yes. Tara Weaver is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tara Weaver was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.