Judith A Waddell, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2742 Issued in KY

Practice address

990 Wilkinson Trce
Bowling Green, KY 42103-3404

Phone

(270) 781-4043

Fax

(270) 781-4196

NPI assigned

Jul 13, 2005

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1164420170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 WILKINSON TRCE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033404",
            "telephone_number": "270-781-4043",
            "fax_number": "270-781-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 WILKINSON TRCE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033404",
            "telephone_number": "270-781-4043",
            "fax_number": "270-781-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "2742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78008794",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelynn Viox, RBT
• Visavis Health Care Medical Group of Ky LLC
• John Eric Voakes, M.D.
• Thomas Vogler, APRN
• Corrie J. Vos, PH.D.
• Renee S. Waddell
• Amanda J Wade, M.A.
• Karen Wade
• Megan Nicole Wade, CSW
• Jeremy Michael Wagoner, LCSW

• All providers in Bowling Green, KY
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.