DR. ANDREW KYLE WATTERS (NPI# 1396860979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396860979 |
Entity Type | Individual |
Full Name | DR. ANDREW KYLE WATTERS |
Credential | MD |
Practice Address |
601 W 2nd St Bloomington IN 47403-2317 |
Mailing Address |
Po Box 1329 Bloomington IN 47402-1329 |
Practice Telephone | 8123539515 |
Mailing Telephone | 8123532154 |
Mailing Fax Number | 8123535228 |
Enumeration Date | 2007-03-20 |
Last Update Date | 2014-05-02 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207P00000X | Emergency Medicine | 01063914A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 200868430 | 05 |
Street Address |
601 W 2ND ST |
City | BLOOMINGTON |
State | IN |
Zip Code | 47403-2317 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992707111 | Brenda Susan Mallory | Physical Medicine & Rehabilitation | 601 W 2nd St, Bloomington, IN 47403-2317 | 2005-06-01 |
1841899747 | Megan Morrison | Dietitian, Registered | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-10-21 |
1598364499 | Stacey Wiseman | Dietitian, Registered | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-10-21 |
1952900904 | Janet Lynn Deckard | Dietitian, Registered | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-10-21 |
1255939484 | Cerina Marie Cunningham | Registered Nurse | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-10-10 |
1043821846 | Riddhi Gandhi | Physician Assistant | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-08-14 |
1417571068 | Colin Laffoon | Nurse Practitioner | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-05-29 |
1891318598 | Kendra Rae Foster | Registered Nurse | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-05-28 |
1548881360 | Lindsay Sanders | Registered Nurse | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-05-04 |
1639798119 | Mona Visnius | Nurse Practitioner | 601 W 2nd St, Bloomington, IN 47403-2317 | 2020-04-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
Find all providers in zip 47403 |
Taxonomy Code | 207P00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710181664 | Obidike Richard Akahara | Emergency Medicine | 1129 Devonshire Curv, Bloomington, MN 55431-5016 | 2007-06-13 |
1801826235 | M Allan Griffith | Emergency Medicine | 1701 East College Ave, Bloomington, IL 61701 | 2006-07-03 |
1639109945 | Emergency Medicine Professionals of Indiana LLC | Emergency Medicine | 4011 So Monroe Medical Park Blvd, Bloomington, IN 47403-9765 | 2006-07-03 |
1326076654 | David Gill | Emergency Medicine | 24 Conway Cir, Bloomington, IL 61704-8285 | 2006-06-28 |
1184691362 | Steven Timothy Tvedte | Emergency Medicine | 5409 Mount Normandale Curv, Bloomington, MN 55437-1019 | 2006-03-07 |
1598730152 | Carson R Harris | Emergency Medicine | 8040 Old Cedar Ave S Ste 100, Bloomington, MN 55425-1205 | 2006-02-17 |
1962474809 | Jonathan D Slater | Emergency Medicine | 2705 Degarmo Dr, Bloomington, IL 61704-9177 | 2006-02-04 |
1487634226 | Luis A Martinez | Emergency Medicine | 4300 Marketpointe Dr Ste 100, Bloomington, MN 55435 | 2006-01-18 |
1043297278 | Ronald C Jenson | Emergency Medicine | 4794 Red Oak Ln, Bloomington, IN 47401-9100 | 2005-12-29 |
1801871934 | Emergency Physicians Professional Association | Emergency Medicine | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435-5435 | 2005-12-13 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 47403 |
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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.