Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeremy Blake Weaver, PA

Individual provider Physician Assistant · NPI 1790014447

Jeremy Blake Weaver, PA is a Physician Assistant in Van Buren, Arkansas. Qualified in 2009, 17 years ago. Practices with Sophia Meyer Family Medicine LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Arkansas and Texas.

Years since qualifying
17
Licensed in
AR, TX
In the registry since
2009
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

620 Broadway St
Van Buren, AR 72956-5830
Phone: (479) 474-5061
Fax: (479) 922-2007
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-843 (AR)
Physician Assistant Taxonomy 363A00000X · Licence PA06492 (TX)

Record details

NPI number1790014447
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 9, 2009
Last updated in NPPESJanuary 26, 2021
Certification dateJanuary 26, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Sophia Meyer Family Medicine Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Van Buren