Keisha L Waters

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

3431 Bridgeland Dr
Bridgeton, MO 63044-2647

Phone

(314) 914-3034

Fax

(314) 464-0331

NPI assigned

Jun 12, 2024

Last updated

Jun 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sunnyside Home Healthcare II LLC

  • Home Health Agency
  • Bridgeton, MO
  • NPI 1306566674
  NPD Authorized official
• Sunnyside Home Healthcare LLC

  • Home Health Agency
  • Bridgeton, MO
  • NPI 1699348466
  NPD Authorized official
• Sunnyside Home Healthcare LLC

  • In Home Supportive Care Agency
  • Bridgeton, MO
  • NPI 1982324240
  NPD Authorized official

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1023850716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 BRIDGELAND DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442647",
            "telephone_number": "314-914-3034",
            "fax_number": "314-464-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 BRIDGELAND DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442647",
            "telephone_number": "314-914-3034",
            "fax_number": "314-464-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KEISHA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kongkeo Thiky Walther, ANP
• William Wang, M.D.
• Victoria Wannemuehler, MS, RDN, LD
• Waqar Ulislam Mirza MD
• Jeniffer Ane Washington
• Alecia Watts, MSW, LMSW
• L Marilyn Weaks, DMD
• Robin Anne Weaver, M.P.T.
• Phillip Michael Webber, PHARMD
• Alexandra Wege, APRN

• Home Health Aide in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Home Health Aide in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.