Eric Waterford

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

4510 Frankford Ave
2ND Floor
Philadelphia, PA 19124-3602

Phone

(215) 831-9882

Fax

(215) 831-9887

NPI assigned

Jan 12, 2015

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1134518376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234004",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 FRANKFORD AVE",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243602",
            "telephone_number": "215-831-9882",
            "fax_number": "215-831-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERFORD",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meguru Watanabe, M.D.
• Mimiko Watanabe
• Tatsuya Watanabe, MD, PHD
• Jessica Watari, DO
• Watchful Homecare Organization LLC
• Watermark Logan Partners, L.P.
• Watermark Logan, LLC
• Christal Waters-Porter
• Beverly Ann Waters, CRNP
• Ellen Kligerman Waters, CRNP

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.