Harris John Waters, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD15831 Issued in OR

Practice address

450 Welch St
Silverton, OR 97381-1934

Phone

(503) 873-5310

Fax

(503) 873-5315

NPI assigned

Sep 28, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Silverton Surgical,LLC

  • Specialist
  • Silverton, OR
  • NPI 1104993286
  NPD (past) Authorized official
• Canby Clinic

  • Naturopath
  • Canby, OR
  • NPI 1699021667
  NPD (past)
• Pioneer Family Medicine PC

  • Family Medicine Physician
  • Canby, OR
  • NPI 1760654479
  NPD (past)

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1124015896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WELCH ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811934",
            "telephone_number": "503-873-5310",
            "fax_number": "503-873-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WELCH ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811934",
            "telephone_number": "503-873-5310",
            "fax_number": "503-873-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "HARRIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-28",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD15831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082755",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTIN",
            "identifier": "109896",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Villarreal
• James Grant Walker, M.D.
• Jacob Wall
• Mika Linette Watanabe, L.AC.
• Sarah M Waterman, MD
• Lydia Espiritu Watson
• Miranda Lynn Watzig, PHARMD
• Andrew P Weitzman, PYSD
• White Oak Wellness LLC
• Tracy Lynn Whitmire, FNP-C

• Specialist in Silverton, OR
• Providers in Silverton, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.