JACK EUGENE WEAVER MD NPI 1902802101

NPI Information

  • NPI: 1902802101
  • Provider Name: JACK EUGENE WEAVER, MD
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 209 S 36TH ST
    MUSKOGEE, OK
    ZIP 74401
  • Phone: (918) 682-7717

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NPI Details

Jack Eugene Weaver, MD is an interventional pain medicine pain medicine in Muskogee, OK with 33 years of experience. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. Jack Eugene Weaver, MD NPI is 1902802101. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1993

The provider's business location address is:

209 S 36TH ST
MUSKOGEE, OK
ZIP 74401-043
Phone: (918) 682-7717
Fax: (918) 682-9434

The NPI 1902802101 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg (HCPCS:J7325)
  • Testing for presence of drug, read by direct observation (HCPCS:80305)
  • Injection, methylprednisolone acetate, 80 mg (HCPCS:J1040)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Testing for presence of drug, by chemistry analyzers (HCPCS:80307)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Aspiration and/or injection of fluid large joint using ultrasound guidance (HCPCS:20611)
  • Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Insertion of spinal neurostimulator electrode array through skin (HCPCS:63650)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64636)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Injection of lower or sacral spine facet joint using imaging guidance, second level (HCPCS:64494)
  • Destruction of peripheral nerve or branch (HCPCS:64640)
  • Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming (HCPCS:95972)
  • Injection of lower or sacral spine facet joint using imaging guidance, second level (HCPCS:64494)
  • X-ray of upper spine, 2-3 views (HCPCS:72040)
  • Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • X-ray of knee, 1-2 views (HCPCS:73560)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Maintenance of spinal canal or brain drug infusion pump by health care professional (HCPCS:95991)
  • Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance (HCPCS:27096)
  • Insertion of spinal neurostimulator generator or receiver (HCPCS:63685)
  • Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • Removal or revision of neurostimulator generator or receiver (HCPCS:63688)
  • X-ray of pelvis, 1-2 views (HCPCS:72170)

The enumeration date for this NPI number is 6/22/2005 and was last updated on 4/10/2018.

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
1174400000XSpecialist19721OKLAHOMANo
2207Q00000XFamily Medicine19721OKLAHOMANo
3208VP0014XPain MedicineInterventional Pain Medicine19721OKLAHOMAYes

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
1100088830AMEDICAIDOKLAHOMA
21841508918OTHEROKLAHOMAGROUP NPI

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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