Water's Edge Family Practice & Wellness Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60091880 Issued in WA

Legal business name

WATER'S EDGE FAMILY PRACTICE & WELLNESS CENTER

Practice address

221 Second Street
Langley, WA 98260

Phone

(360) 221-1060

Fax

(360) 221-1062

NPI assigned

May 7, 2013

Last updated

May 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Annastasia Kovscek, M.D.NPI 1417143256

Title

Owner

Phone

(360) 221-1060

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Annastasia Marie Kovscek, M.D.

  • Family Medicine Physician
  • Langley, WA
  • NPI 1417143256
  NPD (past) Authorized official

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367884800000",
    "number": "1336584119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1327",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982601327",
            "telephone_number": "360-221-1060",
            "fax_number": "360-221-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SECOND STREET",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "98260",
            "telephone_number": "360-221-1060",
            "fax_number": "360-221-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER'S EDGE FAMILY PRACTICE & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A",
        "authorized_official_last_name": "KOVSCEK",
        "authorized_official_first_name": "ANNASTASIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-221-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60091880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• William Noel Ware, LAC.
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• Craig Weiner, D.C.
• David Wilder, LICSW
• Eric Johnson Witherspoon, L.AC.

• Family Medicine Physician in Langley, WA
• Providers in Langley, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.