Individual provider Active NPI

Christopher Darius Waters, OT/R

  • Occupational Therapist
  • Culver City, CA
National Provider Identifier
1255929774
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
21399 Issued in CA
Practice address
6124 Buckingham Pkwy Unit 204
Culver City, CA 90230-7223
Phone
(310) 614-5481
NPI assigned
Jan 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 21399 CA Primary

Addresses

Primary practice location

6124 Buckingham Pkwy Unit 204
Culver City, CA 90230-7223

Mailing address

6124 Buckingham Pkwy Unit 204
Culver City, CA 90230-7223
Phone (310) 614-5481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217002094 CA Practitioner - Occupational Therapist in Private Practice 5395150718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

2001 Wilshire Blvd
Suite 310
Santa Monica, CA 90403-5683
Phone (310) 829-3320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21399CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Select CS Physical Therapy, P.C. Occupational Therapist Current Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Select CS Physical Therapy, P.C. Occupational Therapist Past Accepting new patients

Locations

442 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 998-8764

431 W 7th St
Fl 7
Los Angeles, CA 90014
Phone (213) 624-3556

1310 W Stewart Dr
Ste 404
Orange, CA 92868
Phone (714) 707-6466

935 E Ridgecrest Blvd
Ridgecrest, CA 93555
Phone (760) 371-1411

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1255929774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6124 BUCKINGHAM PKWY UNIT 204",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307223",
            "telephone_number": "310-614-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 BUCKINGHAM PKWY UNIT 204",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307223",
            "telephone_number": "310-614-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CHRISTOPHER",
        "middle_name": "DARIUS",
        "name_prefix": "Mr.",
        "credential": "OT/R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.