DR. BRIAN ROBERT WATERMAN (NPI# 1518158724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518158724 |
| Entity Type | Individual |
| Full Name | DR. BRIAN ROBERT WATERMAN |
| Credential | MD |
| Practice Address |
1901 Mooney St Winston Salem NC 27103-3032 |
| Mailing Address |
Po Box 602658 Charlotte NC 28260-2658 |
| Practice Telephone | 3367168093 |
| Practice Fax Number | 3367169329 |
| Mailing Telephone | (336) 716-2011 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2017-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 2017-01397 | NC | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
2017-01397 | NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275810384 | Brian T Waterman | Counselor | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2011-11-03 |
| Street Address |
1901 MOONEY ST |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-3032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912041773 | Richard Thomas Galinski | Physical Therapist | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2007-02-16 |
| 1134731227 | Wake Forest University Health Sciences | Durable Medical Equipment & Medical Supplies | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2020-08-19 |
| 1073135448 | Charles Ramy Badawy | Physical Therapist | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2020-05-08 |
| 1124517644 | Justin Pfruender | Physical Therapist | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2018-05-10 |
| 1467959627 | Carla Parker | Specialist/Technologist | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2018-04-12 |
| 1992228738 | Edmond Christopher Ina | Specialist/Technologist | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2017-07-24 |
| 1215310123 | Kristen Lee Marion | Physical Therapist | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2015-07-09 |
| 1073862355 | Amanda Whitaker Tipton | Physician Assistant | 1901 Mooney St, Winston Salem, NC 27103-3032 | 2012-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902241805 | Ian Al'khafaji | Orthopaedic Surgery | 2719 Reynolda Rd, Winston Salem, NC 27106 | 2013-05-06 |
| 1992232979 | Novant Medical Group, Inc. | Orthopaedic Surgery | 2337 Winterhaven Ln, Winston Salem, NC 27103-6792 | 2017-05-22 |
| 1710432976 | Novant Medical Group Inc. | Orthopaedic Surgery | 2337 Winterhaven Ln, Winston Salem, NC 27103-6792 | 2016-08-17 |
| 1487875373 | John B. Hubbard | Orthopaedic Surgery | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-05-01 |
| 1790849396 | North Carolina Sports Medicine Institute Pllc | Orthopaedic Surgery | 185 Kimel Park Dr, Suite 201, Winston Salem, NC 27103-6973 | 2006-12-20 |
| 1124070115 | Orthopaedic Specialists of The Carolinas, P.a. | Orthopaedic Surgery | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2006-05-17 |
| 1750354767 | Allston Julius Stubbs | Orthopaedic Surgery | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821354812 | Sunny Patel | Orthopaedic Surgery | 1234 Huffman Mill Rd Dept Of, Burlington, NC 27215 | 2012-04-04 |
| 1174763981 | Brett Andrew Fritsch | Orthopaedic Surgery | Duke Sports Medicine Ctr, 300 Frank Bassett Drive, Durham, NC 27710-0001 | 2009-03-06 |
| 1033366885 | Scotland Orthopedics, Pa | Orthopaedic Surgery | 410 D South Jones Street, Pembroke, NC 28372 | 2008-08-23 |
| 1437315165 | North Carolina Shoulder and Elbow Surgery and Sports Medicine | Orthopaedic Surgery | 900 North Howe St, Southport, NC 28461 | 2008-08-01 |
| 1750542411 | Abby B. Maxwell | Orthopaedic Surgery | 3 Mcdowell St, Suite B, Asheville, NC 28801-4103 | 2008-06-24 |
| 1518130418 | Jeffrey Tweed Spang | Orthopaedic Surgery | University of North Carolina Hospital, Cb# 7055, Chapel Hill, NC 27599-7055 | 2008-04-11 |
| 1184746810 | Kevin Leo Krasinski | Orthopaedic Surgery | 1236 Huffman Mill Rd Ste 1300, Burlington, NC 27215-8700 | 2007-04-04 |
| 1285748970 | Statesville Hma Physician Management, Inc | Orthopaedic Surgery | 340 Signal Hill Dr, Suite A, Statesville, NC 28625-4357 | 2006-08-18 |
| 1467461566 | Timothy Ned Taft | Orthopaedic Surgery | 3154 Bioinformatics Bldg, Cb # 7055 Unc, Chapel Hill, NC 27599-0001 | 2006-08-07 |
| 1447283619 | Private Diagnostic Clinic, Pllc | Orthopaedic Surgery | 5620 Six Forks Rd, Suite 104, Raleigh, NC 27609-8619 | 2006-07-09 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.