Kathleen Anne Waters, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4447 Issued in SC

Practice address

204 N Cedar St Ste 100
Summerville, SC 29483-6453

Phone

(843) 821-2480

Fax

(843) 875-3149

NPI assigned

May 26, 2011

Sex

Female

Sole proprietor

Yes

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 SC

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

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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 and National Provider Directory roles.

• Professional Addiction Services LLC

  • Community/Behavioral Health Agency
  • Summerville, SC
  • NPI 1922583277
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1295028959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N CEDAR ST STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836453",
            "telephone_number": "843-821-2480",
            "fax_number": "843-875-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N CEDAR ST STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836453",
            "telephone_number": "843-821-2480",
            "fax_number": "843-875-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "SC",
            "license": "4447",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Warren
• Barbara A Washington, LMSW
• Jasmine Calvina Washington, MSN, APRN, FNP-C
• Kiana Washington, LMSW
• Waterfall Wellness Center
• Brooke Elizabeth Watson, PA-C
• Wave Physical Therapy LLC
• Bianca M Way
• James H Way, PHD
• We Are Just Like Family, LLC

• Adult Health Nurse Practitioner in Summerville, SC
• Providers in Summerville, SC by specialty
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.