THAD F WAITES (NPI# 1588773774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588773774 |
| Entity Type | Individual |
| Full Name | THAD F WAITES |
| Credential | MD |
| Practice Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012685800 |
| Practice Fax Number | 6012613530 |
| Mailing Telephone | 6012685800 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
06037 | MS | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
06037 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009907150 | 05 | |
| MS | 00016544 | 05 | |
| LA | 1165425 | 05 | |
| MS | RAILROAD MEDICARE | 060005423 | 01 |
| MS | AMERICAN ADMIN GROUP | 1558986 | 01 |
| LA | 1472654 | 05 |
| Street Address |
415 S 28TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-7246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225030372 | Norman Blake Moore Jr. | Nurse Anesthetist, Certified Registered | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2005-06-01 |
| 1457950842 | Tyler Griffin Armstrong | Nurse Anesthetist, Certified Registered | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2020-10-19 |
| 1538776679 | Hattiesburg Clinic, Pa | Clinic/Center | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2020-09-23 |
| 1205446804 | Robert Price Ledbetter | Perfusionist | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2020-08-07 |
| 1972143626 | Jarrod Edward Gant | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7283 | 2020-01-10 |
| 1720625841 | Corey Lyle Gambrell | Nurse Anesthetist, Certified Registered | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-12-09 |
| 1447802103 | Heather Pritchett Bassi | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-07-12 |
| 1891357588 | Dylan Winston Boyd | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-07-02 |
| 1578124186 | Casie Barnes | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2019-06-25 |
| 1992364491 | Stacy Louise Neames | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7283 | 2019-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427251511 | Christopher John Douglas | Internal Medicine | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2007-06-07 |
| 1538200209 | Wesley Physician Services LLC | Internal Medicine | 5001 Hardy St, Hattiesburg, MS 39402-1308 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134761786 | Cardiovascular Health Center Pllc | Internal Medicine | 4211 Hospital St Ste 202, Pascagoula, MS 39581-5310 | 2019-10-16 |
| 1497224174 | Fusion Vascular, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732-3502 | 2018-11-25 |
| 1679730329 | Foluso A Fakorede | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2008-05-20 |
| 1073617775 | Jimmy Darrell Sneed | Internal Medicine | 391 Southcrest Cir Ste 200, Southaven, MS 38671-6729 | 2006-09-12 |
| 1245214196 | Hemraj R. Makwana | Internal Medicine | 520 Willowbrook Rd, Columbus, MS 39705-2015 | 2005-12-05 |
| 1720087257 | Joon K Chang | Internal Medicine | 255 Baptist Blvd, Ste. 401, Columbus, MS 39705-2011 | 2005-07-18 |
| 1154989689 | King and Associates Cardiology Pllc | Internal Medicine | 2323 5th St N, Columbus, MS 39705-2213 | 2019-05-30 |
| 1053873133 | Cms Care of Ms, LLC | Internal Medicine | 460 Briarwood Dr Ste 400, Jackson, MS 39206-3062 | 2019-04-05 |
| 1760975692 | Fusion Vascular Center, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732 | 2018-06-14 |
| 1356712848 | Cardiovascular Solutions of Central Ms Pa | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2015-10-09 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on THAD F WAITES.
| 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.