KRISTI ANN WEAVER – Mental Health Counselor, NPI 1053669903

KRISTI ANN WEAVER is a healthcare provider. based in Bloomington, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 180009792 (IL). The NPI Number for KRISTI ANN WEAVER is 1053669903

Main info

Female
18 Years Of Experience
Name
KRISTI ANN WEAVER
NPI
1053669903
Phone
(309) 827-5351
Address
108 W Market St
Enumeration Date
27 August 2012
Last Update Date
16 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6182832222
Graduation Year
2008 (18 years ago)
PAC ID
4688016025
Group Practice PAC ID
1355679010
Professional Enrollment ID
I20240530001751
Address ID
IL629595899MA4505XSTXX415
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:13State licenses:2Digital endpointsOther names

2,308 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for KRISTI ANN WEAVER

  • 108 W Market St

    Bloomington, IL 617013918

    Phone: (309) 827-5351

    Fax: (309) 829-6808

    Type: Location

  • 109 CALIFORNIA ST

    PO BOX 577

    CARTERVILLE, IL 62918

    Phone: (618) 519-9200

    Fax: (618) 985-4635

    Type: Mailing

  • 400 S LEWIS LN

    CARBONDALE, IL 629013547

    Phone: (618) 519-9200

    Fax: (618) 519-9961

    Type: Location

  • 1190 GRAND OAK DR

    CARBONDALE, IL 629015474

    Phone: (618) 534-0607

    Type: Mailing

  • 2311 S ILLINOIS AVE

    CARBONDALE, IL 629035912

    Phone: (618) 457-6703

    Fax: (618) 549-3734

    Type: Location

  • 902 W MAIN ST

    WEST FRANKFORT, IL 628962210

    Phone: (618) 937-6483

    Fax: (618) 937-1440

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240530001751IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355679010View full group profile

Reviews

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Frequently asked questions

Does KRISTI ANN WEAVER share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KRISTI ANN WEAVER uses 1053669903.
Does CMS list KRISTI ANN WEAVER as active?
Yes — KRISTI ANN WEAVER is active in the NPI listing used on this page.
What is KRISTI ANN WEAVER's specialty?
The listing groups KRISTI ANN WEAVER with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Does KRISTI ANN WEAVER list a practice location?
Patients near Bloomington, Illinois may find KRISTI ANN WEAVER in results; validate coverage separately.
How many locations tie to this NPI?
6 practice locations appear in the available data.

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