Renee Latrese Waters, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

035782 Issued in GA

Practice address

3651 Dawson Forest Rd E
Suite 100
Dawsonville, GA 30534-0404

Phone

(706) 216-7337

Fax

(770) 783-8899

NPI assigned

Mar 15, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319932800000",
    "number": "1144299918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 DAWSON FOREST RD E",
            "address_2": "SUITE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305340404",
            "telephone_number": "706-216-7337",
            "fax_number": "770-783-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 DAWSON FOREST RD E",
            "address_2": "SUITE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305340404",
            "telephone_number": "706-216-7337",
            "fax_number": "770-783-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "RENEE",
        "middle_name": "LATRESE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "035782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000650339D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
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• Wellspring Counseling North Georgia LLC
• Candace L. Wheeler, M.S., LPC
• Morgan Nicole Wheeler, MS, OTR/L
• Whispering Willow
• James Paul Whitcomb, RPH

• Pediatrics Physician in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.