Camille Jordan Waterman

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2130519 Issued in TX

Practice address

1817 Tile Factory Rd
Palestine, TX 75803-8471

Phone

(903) 729-2261

NPI assigned

Aug 27, 2018

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1033690144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22982 COUNTY ROAD 187",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757578158",
            "telephone_number": "903-571-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 TILE FACTORY RD",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758038471",
            "telephone_number": "903-729-2261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 S Bonner St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757662330",
            "country_code": "US",
            "telephone_number": "903-586-9871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "CAMILLE",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2130519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreens
• Davida J Wardell, MD
• McKayla Warren, RN
• Brandy C Watson, M.D.
• Jennifer Danielle Watson, NP
• Rebekah Anne Webb, CCC-SLP
• Sandy Louise Webb, MD
• Ellen M Weber, D.D.S.

• Physical Therapy Assistant in Palestine, TX
• Providers in Palestine, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.