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

Tara Ann Weaver

Individual provider Medical Physician Assistant · NPI 1609736453

Tara Ann Weaver is a Physician Assistant in Columbia, South Carolina. Qualified in 2025, 1 year ago. Licensed in South Carolina.

Years since qualifying
1
Licensed in
SC
In the registry since
2025

Practice location Address checks out

1600 Lake Murray Blvd
Columbia, SC 29212-8623
Phone: (803) 731-9600
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 6140 (SC)

Record details

NPI number1609736453
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 14, 2025
Last updated in NPPESNovember 14, 2025
Certification dateNovember 14, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Columbia