Individual provider Active NPI

Christina Marie Waugh, NP-C

  • Family Nurse Practitioner
  • Petoskey, MI
National Provider Identifier
1316455843
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704328401 Issued in MI
Practice address
560 W Mitchell St Ste 400
Petoskey, MI 49770-2274
Phone
(231) 487-2490
NPI assigned
Jan 18, 2018
Last updated
Jan 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704328401 MI Primary

Addresses

Primary practice location

560 W Mitchell St Ste 400
Petoskey, MI 49770-2274

Mailing address

560 W Mitchell St Ste 400
Petoskey, MI 49770-2274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180223002289 MI Practitioner - Nurse Practitioner 2365703840 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Northern MichiganGroup PAC ID 9931018181, 60 clinicians
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

416 Connable Ave
Petoskey, MI 49770-2212
Phone (231) 487-4000

560 W Mitchell St
Suite 160
Petoskey, MI 49770-2276
Phone (231) 487-3630

560 W Mitchell St
Suite 400
Petoskey, MI 49770-2274
Phone (231) 330-3585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704328401MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group CurrentSince Jan 7, 2024 Accepting new patients
McLaren Central Michigan Current Accepting new patients
McLaren Northern Michigan CurrentSince Sep 23, 2023 Accepting new patients
McLaren Medical Group Nurse Practitioner CurrentSince Jan 7, 2024 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Northern Michigan CurrentSince Sep 23, 2023 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan Past Accepting new patients
McLaren Medical Group Past Accepting new patients

Locations

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

944 N Center Ave
Gaylord, MI 49735
Phone (989) 731-5781

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

560 W Mitchell St
Ste 400
Petoskey, MI 49770
Phone (231) 330-3585

560 W Mitchell St
Ste 402
Petoskey, MI 49770
Phone (231) 487-4760

573 N Bradley Hwy
Rogers City, MI 49779
Phone (989) 734-2171

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1316455843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST STE 400",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST STE 400",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702274",
            "telephone_number": "231-487-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704328401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.