Kristine Anderson Waters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-14056 Issued in NC

Practice address

101 SW Cary Pkwy Ste 210
Cary, NC 27511-5588

Phone

(919) 467-8556

NPI assigned

Mar 4, 2012

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Nova Southeastern College of Osteo Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cary Dermatology Center PAGroup PAC ID 7911981956, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kwaters@directaddress.net

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.

• Cary Dermatology Center, P.a.

  • Health Service Clinic/Center
  • Cary, NC
  • NPI 1942201488
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1330819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1053685354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SW CARY PKWY STE 210",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115588",
            "telephone_number": "919-467-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SW CARY PKWY STE 210",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115588",
            "telephone_number": "919-467-8556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Southpark Blvd Ste A103",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320864162",
            "country_code": "US",
            "telephone_number": "904-342-7765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KRISTINE",
        "middle_name": "ANDERSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-04",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106439",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantel Washington-Mbuthia
• Brenika Natasha Washington, LCMHC
• Ebony Washington
• Matthew B Wasik
• Alexa Waters, MD
• Michelle R. Waters, OTR/L
• Anna Carlton Watkins, MSW, LCSW
• Robert S Watkins, MD
• Sharvae Watkins
• Ashlynn Jarae Watley-Vinson

• Physician Assistant in Cary, NC
• Providers in Cary, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.