Active NPI
James D Waters, MD
- Anesthesiology Physician
- Harrison, AR
National Provider Identifier
1053350066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C7550
- Practice address
- 620 N Main St
Harrison, AR 72601-2911 - Phone
- (870) 414-4000
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C7550 | AR | Primary |
Addresses
Primary practice location
620 N Main St
Harrison, AR 72601-2911
Mailing address
PO Box 432
Mountain Home, AR 72654-0432
Phone (870) 424-7070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128653001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7550 | AR | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303948800000",
"number": "1053350066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 432",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726540432",
"telephone_number": "870-424-7070",
"fax_number": "870-424-6616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N MAIN ST",
"city": "HARRISON",
"state": "AR",
"postal_code": "726012911",
"telephone_number": "870-414-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "JAMES",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2011-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AR",
"license": "C7550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128653001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrison, AR
- Washington Regional Medical System (Ozark Family Practice - Washington Regional)
- Washington Regional Medical System (Washington Regional Primary Care - Main Street)
- Washington Regional Medical System (Walker Heart Institute Harrison Cardiology Clinic)
- Washington Regional Medical System (Crossroads Medical Clinic - Washington Regional)
- Washington Regional Medical System (Harrison Family Practice Clinic - Washington Regional)
- Mattie Elizabeth Watkins
- Fanae Watson, NP
- Watsons Family Medical Clinic
- Judy Wharff, MHPP
- Jeffrey Zack Wheeler, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.