Individual provider Active NPI

Sheree Waterous, PA-C

  • Medical Physician Assistant
  • Atlantis, FL
National Provider Identifier
1285701060
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105530 Issued in FL
Practice address
205 JFK Dr
Suite a
Atlantis, FL 33462-1151
Phone
(561) 432-8935
Fax
(561) 432-8937
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105530 FL Primary

Addresses

Primary practice location

205 JFK Dr
Suite a
Atlantis, FL 33462-1151

Mailing address

5700 Lake Worth Rd
Suite 204
Greenacres, FL 33463-4727
Phone (561) 968-7968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000648 FL Practitioner - Physician Assistant 5092618702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1285701060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 LAKE WORTH RD",
            "address_2": "SUITE 204",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634727",
            "telephone_number": "561-968-7968",
            "fax_number": "561-432-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 JFK DR",
            "address_2": "SUITE A",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621151",
            "telephone_number": "561-432-8935",
            "fax_number": "561-432-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATEROUS",
        "first_name": "SHEREE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.