Diana B Waugh, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704251427 Issued in MI

Practice address

1609 Park Dr
Traverse City, MI 49686-4701

Phone

(231) 947-8920

NPI assigned

Sep 1, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Senior Resources Incorporated

  dba Area Agency on Aging of Northwest Michigan

  • Case Management Agency
  • Traverse City, MI
  • NPI 1295755122
  NPD
• Area Agency on Aging of NW Michigan

  dba Northwest Senior Resources, Inc.

  • Case Management Agency
  • Traverse City, MI
  • NPI 1154564581
  NPD (past)

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1184344863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5946",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496965946",
            "telephone_number": "231-947-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 PARK DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864701",
            "telephone_number": "231-947-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "DIANA",
        "middle_name": "B",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704251427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "waughd@aaanm.org",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Area Agency on Aging of Northwest Michigan",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1609 Park Dr.",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496864701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Waters Edge Assisted Living, LLC
• Nicole Taylor Watson
• Shannon Watson
• Thomas Michael Watson
• Christine Marie Watts, BS, CMT-P, MMT
• Terri L Waugh, PT
• Brandon Weaver
• Alyssa A Webb
• Charles W Webb, MD
• Cindy Webb, L.M.T

• Registered Nurse in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.