WAVERLY CARE CENTER INC2 (NPI# 1780881789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780881789 |
| Entity Type | Organization |
| Organization Name | WAVERLY CARE CENTER INC2 |
| Other Organization Name | VILLAGE HEALTH CENTER |
| Practice Address |
621 E 5th St Waverly OH 45690-1505 |
| Practice Telephone | 7409478670 |
| Practice Fax Number | 7409478680 |
| Mailing Telephone | 7409478670 |
| Mailing Fax Number | 7409478680 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2010-01-25 |
| Authorized Official Name | DR. ROBERT TYREE (PHYSICIAN) |
| Authorized Official Telephone | 7409478670 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35064727 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0213254 | 05 |
| Other Name | Type Code |
|---|---|
| Village Health Center | Doing Business As Name - Organization |
| Street Address |
621 E 5TH ST |
| City | WAVERLY |
| State | OH |
| Zip Code | 45690-1505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225248701 | Bristol Village Homes | Family Medicine | 621 E 5th St, Waverly, OH 45690-1505 | 2007-05-23 |
| 1376883538 | Heather R Howard | Nurse Practitioner | 621 E 5th St, Waverly, OH 45690-1505 | 2013-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767181 | Brandie Mustard | Homemaker | 3018 My Tabor Rd, Waverly, OH 45690 | 2020-10-15 |
| 1225661168 | Kyle Colley | Counselor | 14574 Us Hughway 23, Waverly, OH 45690 | 2020-02-19 |
| 1366082513 | Ryan Rawlins | Counselor | 14574 St. Rt. 23, Waverly, OH 45690 | 2020-01-15 |
| 1700424140 | Jaime Wooldridge | Counselor | 14532 St. Rt. 23, Waverly, OH 45690 | 2019-12-17 |
| 1518513415 | Jacquelyn Irene Sprouse | Counselor | 217 Emmitt Ave, Waverly, OH 45690 | 2019-08-15 |
| 1639634850 | Krista K Leeth | Counselor | 14532 Us Hwy 23, 14534 Us Hwy 23, Waverly, OH 45690 | 2019-02-01 |
| 1881196244 | Kevin Michael Reichert | Counselor | Pike County Recovery Council, 218 East North Street, Waverly, OH 45690 | 2018-03-01 |
| 1619483179 | Ticia Lewis | Counselor | 14532 State Route 23, Waverly, OH 45690 | 2017-12-20 |
| 1205342136 | Criston B Evans | Licensed Practical Nurse | 14532 Us Highway 23, Waverly, OH 45690 | 2017-12-14 |
| 1447763313 | Jody Ryan Colley | Counselor | 14572 St. Rt. 23, Waverly, OH 45690 | 2017-11-14 |
| Find all providers in zip 45690 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568953651 | Tiffany Renee Bagwell | Family Medicine | 401 Gregson Pl, Waverly, TN 37185-2925 | 2018-05-23 |
| 1326574062 | Nicole Rex | Family Medicine | 135 Cedar Hill Dr, Waverly, OH 45690-9142 | 2017-05-01 |
| 1518301522 | Kimberly Ann Kabernagel | Family Medicine | 12 Lily Lake Rd, Waverly, PA 18471-0036 | 2013-04-21 |
| 1225224405 | Sumita Aggarwal | Family Medicine | 227 Valley View Dr., Waverly, OH 45690 | 2007-09-20 |
| 1225248701 | Bristol Village Homes | Family Medicine | 621 E 5th St, Waverly, OH 45690-1505 | 2007-05-23 |
| 1386794816 | Lawrence Richard Jackson Jr. | Family Medicine | 102 Hillwood Dr, Waverly, TN 37185 | 2007-01-10 |
| 1548379381 | Terry A Johnson | Family Medicine | 715 W Emmitt Ave, Waverly, OH 45690-1015 | 2006-08-29 |
| 1437176286 | Harry T Kittaka | Family Medicine | 12340 State Route 104, Waverly, OH 45690-8968 | 2006-07-17 |
| 1053390906 | George Coleman | Family Medicine | 344 W Main St, Waverly, VA 23890-3235 | 2006-01-10 |
| 1467430181 | Timothy C Horrigan | Family Medicine | 217 20th St Nw, Waverly, IA 50677 | 2006-01-03 |
| Find all providers in WAVERLY | ||||
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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.