DR. TRAVIS WEAVER D.O. NPI 1063808772

NPI Information

  • NPI: 1063808772
  • Provider Name: DR. TRAVIS WEAVER, D.O.
  • Classification: Internal Medicine - 207RE0101X
  • Specialization: Endocrinology, Diabetes & Metabolism
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1815 E IRELAND RD
    SOUTH BEND, IN
    ZIP 46614
  • Phone: (574) 647-1700

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NPI Details

DR. Travis Weaver, D.O. is an endocrinology and diabetes and metabolism internal medicine in South Bend, IN with 11 years of experience. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. DR. Travis Weaver, D.O. NPI is 1063808772. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduation Year:2015

The provider's business location address is:

1815 E IRELAND RD
SOUTH BEND, IN
ZIP 46614-845
Phone: (574) 647-1700
Fax: (574) 647-7572

The NPI 1063808772 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/9/2015 and was last updated on 12/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RE0101XInternal MedicineEndocrinology, Diabetes & Metabolism0102204753VIRGINIANo
2207RE0101XInternal MedicineEndocrinology, Diabetes & Metabolism02007513AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300083607MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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