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JACK E WEAVER, MD PC
NPI 1841508918
Internal Medicine - Sports Medicine in Muskogee, OK

Active since September 22, 2010CLIA 37D2077468 · Waiver
209 S 36TH ST, MUSKOGEE, OK 74401(918) 682-7717(918) 682-9434 Get Directions Write a Review

NPPES record last updated: August 25, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack E Weaver, Md Pc NPPES

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

JACK E WEAVER, MD PC (NPI 1841508918) is a healthcare organization registered as a sports medicine in Muskogee, Oklahoma and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through July 12, 2027 and lists Jack E Weaver, Owner, as its authorized official.

NPPES Registry Identity

NPI1841508918
Entity TypeOrganization
Primary Taxonomy207RS0010X
Legal Business NameJACK E WEAVER, MD PC
Location Address209 S 36TH STMuskogee, OK 74401-5043
Mailing Address209 S 36th StMuskogee, OK 74401-5043 · (918) 682-7717 · Fax (918) 682-9434
Phone(918) 682-7717
Fax(918) 682-9434
Organization SubpartNo
Authorized OfficialJack E WeaverOwner · (918) 682-7717
Enumeration DateSeptember 22, 2010
Last NPPES UpdateAugust 25, 2015
✔ NPI 1841508918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0010X
Definition
An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual.
209 S 36TH ST, Muskogee, OK 74401
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Other Identifiers 2

Medicare NSC6346320001OK
Medicaid100088830AOK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2077468

Jack E Weaver Md-Pc · Muskogee, OK
Active · expires Jul 12, 2027
CLIA Number37D2077468
Laboratory TypePhysician Office
Certificate Effective DateJuly 13, 2025
Certificate Expiration DateJuly 12, 2027
Laboratory DirectorJack E. Weaver
Laboratory Phone(918) 682-7717
Laboratory LocationJack E Weaver Md-Pc209 S 36th St, Muskogee, OK 74401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

JOHN V TEDESCO DO PA
Surgery
209 S 36TH ST, SUITE A
MUSKOGEE, OK 74401
Muskogee County (918) 913-9513
FRED MICHAEL RUEFER MD
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 682-7717
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Orthopaedic Surgery
209 S 36TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 682-7717
FRED M RUEFER, MD PC
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 682-7717
JENNIFER MILLER ATC, LAT, OTC, NREMT
Specialist/Technologist (Athletic Trainer)
209 S 36TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 682-7717
GUY E. GROOMS, M.D., P.C.
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 682-7717
DENNIS RIVERO MD
Orthopaedic Surgery
209 S 36TH ST, SUITE A
MUSKOGEE, OK 74401
Muskogee County (918) 683-8288
MUSKOGEE BONE & JOINT & SPORTS MEDICINE
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Muskogee County (918) 682-7717

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 Jack E Weaver, MD PC's NPI number?

The NPI number for Jack E Weaver, MD PC is 1841508918. It was assigned to this organization in the NPPES registry on September 22, 2010.

Where is Jack E Weaver, MD PC located?

Jack E Weaver, MD PC is located at 209 S 36th St, Muskogee, OK 74401. The listed phone number is (918) 682-7717.

What is Jack E Weaver, MD PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

Does Jack E Weaver, MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2077468) is associated with this NPI, valid through July 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jack E Weaver, MD PC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Jack E Weaver, MD PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack E Weaver, MD PC was last updated on August 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.