NPIMap

Organization Active NPI

Waterman Communities Inc

  • Physical Therapy Clinic/Center
  • Mount Dora, FL
National Provider Identifier
1144053752
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
WATERMAN COMMUNITIES INC
Doing business as
Waterman Village Outpatient Therapy
Practice address
500 Waterman Ave
Mount Dora, FL 32757-9567
Phone
(352) 383-0051
NPI assigned
Aug 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kendra Criss
Title
Exec Dir of Home & Community SVS
Phone
(352) 383-0051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

500 Waterman Ave
Mount Dora, FL 32757-9567

Mailing address

250 Brookfield Ave
Mount Dora, FL 32757-9559
Phone (352) 383-0051

Other names 1

  • Waterman Village Outpatient Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250107002259 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9335207190 Practice locations: Mount Dora, FL

Outpatient physical therapy / speech pathology certification: CCN 696556

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WATERMAN VILLAGE OUTPATIENT THERAPY
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Aug 26, 2025
Last certification
Aug 26, 2025
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
500 Waterman Ave
Mount Dora, FL 32757

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Waterman Communities Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

445 Waterman Ave
Mount Dora, FL 32757
Phone (352) 357-5055

250 Brookfield Ave
Mount Dora, FL 32757

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1144053752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BROOKFIELD AVE",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327579559",
            "telephone_number": "352-383-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WATERMAN AVE",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327579567",
            "telephone_number": "352-383-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERMAN COMMUNITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "CRISS",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "EXEC DIR OF HOME & COMMUNITY SVS",
        "authorized_official_telephone_number": "352-383-0051",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterman Village Outpatient Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.