Active NPI
Donnie R Waits, LPN, PDN, A.S.
- Licensed Practical Nurse
- Lockport, NY
National Provider Identifier
1134463805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 310806
- Practice address
- 269 Beattie Ave
Apt 4
Lockport, NY 14094-5646 - Phone
- (585) 735-5202
- NPI assigned
- Nov 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 310806 | NY | Primary |
Addresses
Primary practice location
269 Beattie Ave
Apt 4
Lockport, NY 14094-5646
Mailing address
269 Beattie Ave
Apt 4
Lockport, NY 14094-5646
Phone (585) 735-5202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03522227 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Associate of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482364800000",
"number": "1134463805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 BEATTIE AVE",
"address_2": "APT 4",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140945646",
"telephone_number": "585-735-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 BEATTIE AVE",
"address_2": "APT 4",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140945646",
"telephone_number": "585-735-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITS",
"first_name": "DONNIE",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "LPN, PDN, A.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-20",
"last_updated": "2016-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "310806",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03522227",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.