DR. ANDREW KYLE WATTERS


Address: 601 W 2nd St, Bloomington, IN 47403-2317
Phone: 8123539515

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207P00000X Emergency Medicine 01063914A IN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IN 200868430 05

Office Location

Street Address 601 W 2ND ST
City BLOOMINGTON
State IN
Zip Code 47403-2317

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City BLOOMINGTON
Zip Code 47403

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Dataset Information

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.

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