Michelle Jordon Waters, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

27008 Issued in TN

Practice address

310 N State of Franklin Rd
Johnson City, TN 37604-6008

Phone

(423) 328-0163

Fax

(423) 491-8109

NPI assigned

Feb 18, 2020

Last updated

Jun 3, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Lincoln Memorial University Medical Department, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Vein Center PLLCGroup PAC ID 2264727627, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Legacy Vein Center PLLC

  • Vascular Surgery Physician
  • Johnson City, TN
  • NPI 1477972933

  VA

  Medicare reassignment Care Compare group NPD
• Medical Education Assistance Corporation

  dba ETSU Physicians and Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  Medicare reassignment NPD
• Legacy Vein Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Sevierville, TN
  • NPI 1770158859
  NPD

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1285267369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-328-0163",
            "fax_number": "423-491-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-328-0163",
            "fax_number": "423-491-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MICHELLE",
        "middle_name": "JORDON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Watauga Pathology Associates PC
• Watauga Pathology Associates PC
• Watauga Recovery Center
• Watauga Recovery Center Morristown P.C.
• Amy Elizabeth Waters, MS, RD, IBCLC
• Amber Laine Watson, DO
• Lorena Watson
• Scott Dean Watson, MD
• Ahmad A Wattad, MD
• Christopher James Watts, PHARM.D

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.