JEREMY WARD WATERS (NPI# 1043536261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043536261 |
| Entity Type | Individual |
| Full Name | JEREMY WARD WATERS |
| Credential | DO |
| Practice Address |
151 Anderson Ln Waterford OH 45786-5312 |
| Mailing Address |
Po Box 449 Marietta OH 45750-0449 |
| Practice Telephone | 7409842332 |
| Practice Fax Number | 7409844435 |
| Mailing Telephone | 7403744500 |
| Mailing Fax Number | 7403745887 |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2020-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 34010331 | OH | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 34010331 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0072159 | 05 | |
| WV | 3810024361 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 401 Matthew St, Marietta, OH 457501635 | 7403761994 | 7403747701 |
| 1106 Colegate Dr, Marietta, OH 457501323 | 7405682000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760452049 | Jeremy J Waters | Family Medicine | 606 N 3rd Ave, Suite 101, Sandpoint, ID 83864-1594 | 2006-01-26 |
| Street Address |
151 ANDERSON LN |
| City | WATERFORD |
| State | OH |
| Zip Code | 45786-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023013430 | Vickie Lea Deleruyelle | Nurse Practitioner | 151 Anderson Ln, Waterford, OH 45786-5312 | 2005-06-14 |
| 1851797377 | Patricia Davidson | Nurse Practitioner | 151 Anderson Ln, Waterford, OH 45786-5312 | 2014-11-11 |
| 1780086538 | Rachel L March | Nurse Practitioner | 151 Anderson Ln, Waterford, OH 45786-5312 | 2014-09-24 |
| 1285687020 | Selby General Hospital, Inc. | Family Medicine | 151 Anderson Ln, Waterford, OH 45786-5312 | 2006-05-19 |
| 1043215338 | Gary G Waters | Emergency Medicine | 151 Anderson Ln, Waterford, OH 45786-5312 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043777113 | Joslynn Trail | Specialist/Technologist | 19701 Oh-339, Waterford, OH 45786 | 2019-02-26 |
| 1467691352 | Wolf Creek Local School District | Local Education Agency (LEA) | 330 Main Street, Waterford, OH 45786-0067 | 2009-02-17 |
| 1164737987 | Darla J Schafer | Licensed Practical Nurse | 16372 State Route 676, Waterford, OH 45786-5113 | 2010-08-17 |
| 1356881015 | Hayli Hanson | Home Health Aide | 26 Maple Cir, Waterford, OH 45786-5321 | 2017-02-28 |
| 1346207016 | Lisa Guiler | Licensed Practical Nurse | 1438 Milner Rd, Waterford, OH 45786-6014 | 2006-04-27 |
| 1124346077 | Marie Ellen Russell | Licensed Practical Nurse | 165 Sunset Ln, Waterford, OH 45786-6337 | 2010-05-16 |
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124548938 | Medpal Health Clinic PC | Internal Medicine | 6743 Highland Rd Ste 5, Waterford, MI 48327-1654 | 2017-06-22 |
| 1033594106 | Atchoo Medical Practice Pllc | Internal Medicine | 4515 Highland Rd, Waterford, MI 48328-1172 | 2015-07-29 |
| 1528487246 | Stephanie Coleman | Internal Medicine | 5210 Highland Rd Ste 201, Waterford, MI 48327-1970 | 2014-04-09 |
| 1659717932 | Waterford Urgent Care PC | Internal Medicine | 5800 Highland Rd, Waterford, MI 48327-1827 | 2013-05-14 |
| 1295099372 | Candi Mcculloch | Internal Medicine | 38 Shawandassee Rd, Waterford, CT 06385-1419 | 2012-07-03 |
| 1194085076 | Meghana Rao Brito | Internal Medicine | 196 Waterford Pkwy S Ste 103, Waterford, CT 06385 | 2012-05-24 |
| 1316072531 | Paunel Grivej Md PC | Internal Medicine | 2801 Elizabeth Lake Road, Waterford, MI 48328 | 2007-02-21 |
| 1841363009 | Amita N Nair | Internal Medicine | 158 Saratoga Ave., Waterford Health Center, Waterford, NY 12188 | 2006-11-16 |
| 1265520191 | Benjamin R Newton | Internal Medicine | 230 Waterford Parkway South, Suite 201, Waterford, CT 06385 | 2006-10-10 |
| 1588762538 | Krishnamoorthi Krishnamoorthi | Internal Medicine | 324 F St, Waterford, CA 95386-9013 | 2006-09-20 |
| Find all providers in WATERFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.