Kanyetta Waters

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5915 S Emerson Ave Ste 100
Indianapolis, IN 46237-1972

Phone

(317) 567-9307

NPI assigned

Oct 16, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Nurtureher Maternal Wellness Center, LLC

  • Case Manager/Care Coordinator
  • Indianapolis, IN
  • NPI 1215889589
  NPD Authorized official
• Circle City ABA

  • Behavior Analyst
  • Lafayette, IN
  • NPI 1235676990
  NPD (past)

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1346116274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6238 CAVE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462591675",
            "telephone_number": "773-807-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 S EMERSON AVE STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462371972",
            "telephone_number": "317-567-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KANYETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Reese Watanabe, M.D., PH.D.
• Watch Over Me Personal Care Services LLC
• Watch Over Me Personal Care Services LLC
• Lenore Mikel Waters-Tyler
• Joshua Aaron Waters, MD
• Nevaeh K Waters
• Adele Watfa, MD
• Cynthia Diane Wathen, BSN, SANE-A, SANE-P
• Elizabeth Wathen, RD
• Michael Wathen

• Behavior Technician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Behavior Technician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.