Timothy Roy Waterman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3561 Issued in SD

Practice address

815 1St Ave SE
Suite 104
Aberdeen, SD 57401-4602

Phone

(605) 622-5458

Fax

(605) 622-5473

NPI assigned

Mar 22, 2006

Last updated

Jul 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avera St Lukes

  • General Acute Care Hospital
  • Aberdeen, SD
  • NPI 1457309270
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1326007899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574021460",
            "telephone_number": "605-622-5458",
            "fax_number": "605-622-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 1ST AVE SE",
            "address_2": "SUITE 104",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014602",
            "telephone_number": "605-622-5458",
            "fax_number": "605-622-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "TIMOTHY",
        "middle_name": "ROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "3561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002550",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin C Ward, D.O.
• Richard Allen Ward III
• Peter Joseph Warhol, M.D.
• Ellen C Washenberger, LPCMH
• Wayne L Washenberger, PAC
• Claire Wattier, FNP-C
• Webb Company Inc.
• Jonathan Webb, PEDORTHIST
• Christa M Weber, OT
• James Mathew Weekly, M.D.

• Internal Medicine Physician in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• Internal Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.