Kenneth Wayne Waddell Jr., NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN249530 Issued in GA

Practice address

120 N Lee St Ste a
Forsyth, GA 31029

Phone

(478) 994-0437

NPI assigned

Jul 17, 2018

Last updated

Jul 18, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

The Medical Center of Central Georgia Inc.Group PAC ID 3678477445, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
• Monroe County Hospital Hospital, Forsyth, GA, CCN 111318

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwaddell433780@carolinashealthcaresystem.direct-ci.com

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.

• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482
  Medicare reassignment Care Compare group NPD
• The Medical Center of Central Georgia Inc.

  dba Atrium Health Navicent At Home

  • Home Health Agency
  • Macon, GA
  • NPI 1831287655
  Medicare reassignment Care Compare group NPD
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  NPD
• Central Georgia Family Medicine, LLC

  • Family Medicine Physician
  • Forsyth, GA
  • NPI 1730484353
  NPD (past)

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

• The Hospital Authority of Monroe County, Georgia

  dba Monroe County Hospital

  • Critical Access Hospital
  • Forsyth, GA
  • NPI 1770684284
  Care Compare affiliation
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  Care Compare affiliation

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1124504782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N LEE ST STE A",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310292122",
            "telephone_number": "478-994-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N LEE ST STE A",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "31029",
            "telephone_number": "478-994-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "name_suffix": "Jr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN249530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• U Save It Pharmacy Inc (U Save It Pharmacy #21)
• United Rehab Inc (United Rehab of Forsyth)
• United Rehab Inc (United Rehab of Mornoe)
• Village Podiatry Group, P.C.
• Vision Savers, Inc
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0907)
• Marion Steven Walker I, D.C.
• Taisia D Walker, OTR
• Antonio Slvester Washington, MD
• Zackary Jake Whitaker, CRNA

• Nurse Practitioner in Forsyth, GA
• Providers in Forsyth, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.