Charles Eddie Waters, PHARMD, BCPS, CGP

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

0000036217 Issued in TN

Practice address

1411 W Baddour Pkwy
Lebanon, TN 37087-2513

Phone

(678) 314-0983

NPI assigned

Jun 28, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1013114685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "678-314-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "678-314-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CHARLES",
        "middle_name": "EDDIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCPS, CGP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TN",
            "license": "0000036217",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH023088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William C Wallace, PT
• Tammie Wampler, PA-C
• Brooke Warren, APN
• Larimore C Warren, M.D., P.C.
• Marla Renee Warren, NURSE PRACTITIONER
• Mary Elizabeth Watts, D.D.S.
• Wayne O. Wells, M.D.
• Brandon Craig Weber, PHARMD
• Wells Ness
• Wayne O Wells, M.D.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.