Watermark Home Care of Southern Arizona, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA4958 Issued in AZ

Legal business name

WATERMARK HOME CARE OF SOUTHERN ARIZONA, LLC

Doing business as

Watermark at Home

Practice address

5830 N Fountains Ave
Tucson, AZ 85704-2869

Phone

(520) 886-4400

Fax

(520) 290-1900

NPI assigned

Dec 10, 2010

Organization subpart

No

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

Authorized official

Name

Mr. David Barnes

Title

Managing Member

Phone

(520) 797-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Watermark at Home Doing business as

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1083917199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W RUDASILL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047800",
            "telephone_number": "520-797-4000",
            "fax_number": "520-797-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 N FOUNTAINS AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857042869",
            "telephone_number": "520-886-4400",
            "fax_number": "520-290-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERMARK HOME CARE OF SOUTHERN ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "520-797-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA4958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194925",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watermark at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Atal Nassratullah Wassimi, PHARMD
• Isabella Waszkiewicz
• Kaitlin Nicole Watchey, DPT
• Richard Watchman, LPC
• Anna L Waterbrook, MD
• Cassandra Waters, LPN
• Heather Waters, FNP-C
• Michelle Waters, FNP
• Donald Etienne Wathieu, MD
• Lauren Watins

• Home Health Agency in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.

Verify at the official NPI Registry.