Active NPI
Michael Waters, IDC
- Independent Duty Corpsman
- Thurmont, MD
National Provider Identifier
1316147457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 14900 Park Central Road
Naval Support Facility
Thurmont, MD 21788 - Phone
- (301) 271-1460
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
14900 Park Central Road
Naval Support Facility
Thurmont, MD 21788
Mailing address
10384 Chamberlin Court East
Waldorf, MD 20601
Phone (301) 535-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184716800000",
"number": "1316147457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10384 CHAMBERLIN COURT EAST",
"city": "WALDORF",
"state": "MD",
"postal_code": "20601",
"telephone_number": "301-535-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14900 PARK CENTRAL ROAD",
"address_2": "NAVAL SUPPORT FACILITY",
"city": "THURMONT",
"state": "MD",
"postal_code": "21788",
"telephone_number": "301-271-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "IDC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thurmont, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.