KELLY RAE WEAVER CPNP-PC
NPI 1881318756
Nurse Practitioner - Pediatrics in Shreveport, LA
About Kelly Rae Weaver Cpnp-pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY RAE WEAVER CPNP-PC (NPI 1881318756) is an individual pediatrics provider in Shreveport, Louisiana, licensed in Louisiana (226455) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Rae Weaver Cpnp-pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelly Weaver reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Shreveport, LA 71103
- Reassigned Medicare billing, Louisiana enrollment
- 1,167 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 71101 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.
SHREVEPORT, LA 71101
SHREVEPORT, LA 71101
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 Kelly Weaver's NPI number?
The NPI number for Kelly Weaver is 1881318756. It was assigned to this individual provider in the NPPES registry on October 3, 2022.
Where is Kelly Weaver located?
Kelly Weaver practices at 1 Saint Mary Pl, Shreveport, LA 71101. The listed phone number is (318) 272-3208.
What is Kelly Weaver's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Kelly Weaver enrolled in Medicare?
Yes. Kelly Weaver is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelly Weaver's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Weaver reassigns Medicare benefits to Lsu Health Sciences Center Shreveport Faculty Group Practice (Shreveport, LA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Weaver's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Weaver accept?
Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Kelly Weaver 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 Kelly Weaver was last updated on October 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kelly Rae Weaver, CPNP-PC · NPI 1881318756
Pediatrics physician in Shreveport, Louisiana. Individual provider, active in the CMS NPPES registry since October 3, 2022.
## Identity
- **NPI:** 1881318756 (Entity type: Individual)
- **Enumerated:** October 3, 2022
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 226455 (Louisiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 SAINT MARY PL, Shreveport, LA 71101-4307
- **Phone:** (318) 272-3208
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Lsu Health Sciences Center Shreveport Faculty Group Practice (NPI 1013374222, Shreveport, LA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 4, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1881318756) · Data from the CMS NPPES public registry.