Christannah M Waters, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

239493 Issued in MA

Practice address

62 Brown St
Suite 405
Haverhill, MA 01830-6778

Phone

(978) 912-7450

Fax

(978) 912-7420

NPI assigned

May 12, 2009

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

Other identifiers 5

Other names 1

• Christannah M Domin Former name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Loyola University of Chicago, Stritch School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kronos Health PLLCGroup PAC ID 3779881636, 9 clinicians

Essex County OBGYN Assoc IncGroup PAC ID 6204829062, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
• Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029
• Holy Family Hospital Hospital, Methuen, MA, CCN 220080
• Parkland Medical Center Hospital, Derry, NH, CCN 300017
• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwaters478039@direct.bilh.masshiway.net

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

• Essex County OBGYN Assoc Inc

  • Obstetrics & Gynecology Physician
  • Beverly, MA
  • NPI 1538275870
  Medicare reassignment Care Compare group NPD
• Kronos Health PLLC

  • Family Medicine Physician
  • Acton, MA
  • NPI 1053777839
  Medicare reassignment Care Compare group
• Revere Medical of Massachusetts, PC

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1336976539
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Kronos Health Geriatrics, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Lawrence, MA
  • NPI 1972216836
  Medicare reassignment
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Beth Israel Lahey Health Specialty Care, Inc.

  • Internal Medicine Physician
  • Gloucester, MA
  • NPI 1235147760
  NPD (past)
• River Valley Infectious Disease Specialists Inc.

  • Infectious Disease Physician
  • Newburyport, MA
  • NPI 1366712002
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Anna Jaques Hospital

  • General Acute Care Hospital
  • Newburyport, MA
  • NPI 1992779482
  Care Compare affiliation
• Lawrence General Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation
• LG Newcorp Inc

  • General Acute Care Hospital
  • Methuen, MA
  • NPI 1265267991
  Care Compare affiliation
• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  Care Compare affiliation
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  Care Compare affiliation
• HCA Health Services of New Hampshire Inc

  • General Acute Care Hospital
  • Derry, NH
  • NPI 1174570683
  Care Compare affiliation

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1104050681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BROWN ST",
            "address_2": "SUITE 405",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306778",
            "telephone_number": "978-912-7450",
            "fax_number": "978-912-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BROWN ST",
            "address_2": "SUITE 405",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306778",
            "telephone_number": "978-912-7450",
            "fax_number": "978-912-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CHRISTANNAH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "239493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110083619A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "747307",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA148729",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8627124",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9805333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTANNAH",
            "last_name": "DOMIN",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Celine N Wang, DDS
• David Earle Warwick Jr., ATC
• Water Street Family Dental PC
• Randall L Waterman, M.D
• Amanda Kay Waters, MED, LMHC
• Nancy E Weimar, LCSW
• Evelyn Weiss, RPH, BCPS
• Abigail Welch
• April Weldon
• Cinda Lou Wentworth

• Obstetrics & Gynecology Physician in Haverhill, MA
• Providers in Haverhill, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.