Carrie Lee Waters, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

104038 Issued in NC

Practice address

1124 Gallery Park LN
Wilmington, NC 28412-1142

Phone

(910) 617-6705

NPI assigned

Jan 24, 2007

Last updated

Jan 20, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
• Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carrie.waters.p1@direct.wilmingtonhealth.nextgenshare.com

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.

• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group NPD
• Pelican Family Medicine, P.a.

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1669480042
  Medicare reassignment NPD
• Pelican Family Medicine, P.a.

  dba Pelican Family Medicine at Physicians Drive

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1326678236
  NPD
• Wha Medical Clinic PLLC

  • Endoscopy Clinic/Center
  • Wilmington, NC
  • NPI 1083889091
  NPD
• Wilmington ASC LLC

  dba Wilmington Health Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1548456478
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brunswick Community Hospital, LLC

  dba Novant Health Brunswick Medical Center

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  Care Compare affiliation
• Novant Health New Hanover Regional Medical Center LLC

  dba Novant Health New Hanover Regional Medical Center

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation
• Well Care Home Health, Inc

  • Home Health Agency
  • Wilmington, NC
  • NPI 1760470660
  Care Compare affiliation

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1285789610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 GALLERY PARK LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121142",
            "telephone_number": "910-617-6705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5429 Wrightsville Ave",
            "address_2": "Pelican Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036513",
            "country_code": "US",
            "telephone_number": "910-792-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CARRIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "104038",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "104038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Alix Warta, MD
• Valerie Nicole Warthen, PMHNP
• Jenny Hines Warwick, O.D.
• Xandria Renee Brinkley Washam, LCSWA
• Jamie Myron Washington, LPC-A
• Pearlie Bradford Watkins III, MD
• Sarah Watkins
• Steven Watkins, R.PH.
• Erin Lynn Watlington, M.A., M.DIV,, LPC
• Elizabeth W Watson, LCMHCA

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.