JACK W MCWATTERS (NPI# 1083681118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083681118 |
| Entity Type | Individual |
| Full Name | JACK W MCWATTERS |
| Credential | MD |
| Practice Address |
11085 Little Patuxent Pkwy Suite 101 Columbia MD 21044-2983 |
| Practice Telephone | 4109977979 |
| Practice Fax Number | 4109979231 |
| Mailing Telephone | 4109977979 |
| Mailing Fax Number | 4109979231 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2009-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | D27237 | MD | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST BCBS PPO,SPP,BC | 0005 | 01 |
| MD | CAREFIRST BCBS MD | 35016302 | 01 |
| MD | AMERIGROUP | 04071 | 01 |
| MD | UNITED HEALTHCARE | 2500675 | 01 |
| MD | AETNA HEALTHCARE NON-HMO | 4105495 | 01 |
| MD | MAMSI CARDIOLOGY | 225079 | 01 |
| MD | AETNA HEALTHCARE HMO | 0481422 | 01 |
| MD | 403161000 | 05 | |
| MD | JHHC | 21750 | 01 |
| Street Address |
11085 LITTLE PATUXENT PKWY SUITE 101 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21044-2983 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497750541 | Francis Chuidian | Internal Medicine | 11085 Little Patuxent Pkwy, Suite 202, Columbia, MD 21044-2983 | 2005-06-16 |
| 1851708150 | Jodi Yatto | Speech-Language Pathologist | 11085 Little Patuxent Pkwy, Suite 101, Columbia, MD 21044-2983 | 2014-07-18 |
| 1568730414 | Columbia Patient Care Associates, LLC | Internal Medicine | 11085 Little Patuxent Pkwy, Medical Arts Bldg - Ste L001, Columbia, MD 21044-2983 | 2011-12-07 |
| 1730405283 | Jessica Ann Cronin | Anesthesiology | 11085 Little Patuxent Pkwy, Medical Arts Bldg, 004, Columbia, MD 21044-2983 | 2010-04-08 |
| 1457516940 | Physical Therapy Partners, Incorporated | Clinic/Center | 11085 Little Patuxent Pkwy, Suite 207, Columbia, MD 21044-2983 | 2008-07-23 |
| 1407034390 | Wendy M. Jackson | Pharmacist | 11085 Little Patuxent Pkwy, Columbia, MD 21044-2983 | 2008-02-04 |
| 1235317249 | Alan Goldstein | Pharmacist | 11085 Little Patuxent Pkwy, Columbia, MD 21044-2983 | 2008-02-01 |
| 1053508598 | Sheetal Patel | Physical Therapist | 11085 Little Patuxent Pkwy, Physical Therapy Partners, Suite 207, Columbia, MD 21044-2983 | 2007-09-28 |
| 1154512549 | Zeenat Nadeem Hashmi | Family Medicine | 11085 Little Patuxent Pkwy, Suite 104, Columbia, MD 21044-2983 | 2007-08-09 |
| 1578771606 | Jo-hsin Chen | Psychiatry & Neurology | 11085 Little Patuxent Pkwy, Suite 212, Columbia, MD 21044-2983 | 2007-05-21 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1821699331 | Brightview Columbia, LLC | Alzheimer Center (Dementia Center) | 6670 Martin Road, Columbia, MD 21044 | 2020-11-03 |
| 1689291544 | Diana Matthews | Physical Therapist | 6016 Jerrys Drive, Columbia, MD 21044 | 2020-06-26 |
| 1902380926 | Bagiwa Healthcare Services LLC | Nursing Care | 10630 Little Patuxent Park Way, Suite 314i, Colombia, MD 21044 | 2018-09-17 |
| 1295228245 | April Bloom Assisted Living, LLC | Assisted Living Facility | 5037 East Durham Rd, Columbia, MD 21044 | 2018-06-13 |
| 1437659562 | La Shawna A Obame | Counselor | 10451 Twin Rivers Rd Ste 100, Columbia, MD 21044 | 2018-02-15 |
| 1205335262 | Rashida Annette Winestock | Registered Nurse | 10440 Little Patuxent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1215436274 | Terri Lynn Buzby | Registered Nurse | 10440 Little Patuxuent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1134628191 | Sarah Elizabeth Stiltner | Registered Nurse | 10440 Little Patuxent Pkwy Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1326547381 | David Oliver Sloan Jr. | Registered Nurse | 10440 Little Patuxent Parkway Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1467950980 | Jill Sheppard Davenport | Nutritionist | 10801 Hickory Ridge Rd Suite 215, C/o Holistic Child Psychiatry, Columbia, MD 21044 | 2018-01-30 |
| Find all providers in zip 21044 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1790167690 | Wanda Al-lahabi | Specialist | 1030 St. Andrews Rd., Suite B-3, Columbia, SC 29210 | 2015-06-26 |
| 1235530296 | Touch and Agree Solutions | Specialist | 10724 Cordage Walk, Columbia, MD 21044-3641 | 2014-09-09 |
| 1033521711 | Charles Crawhorn | Specialist | 989 Portland Rd, Columbia, KY 42728-5283 | 2014-05-29 |
| 1235556028 | Allison Hammond | Specialist | 5500 Knoll North Dr Ste 150, Columbia, MD 21045-2476 | 2014-03-18 |
| 1588908024 | Frederick T Garner, Md, LLC | Specialist | 200 Arbor Lake Dr Ste 120, Columbia, SC 29223-4516 | 2012-11-21 |
| Find all providers in COLUMBIA | ||||
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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.