Ann C. Waterman Doctor of Optometry, P.C.
Organization Active NPI Optometrist · Liberty, MO
NPI 1366577272 · NPPES record last updated Sep 8, 2022
Key facts
- NPI
- 1366577272
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ANN C. WATERMAN DOCTOR OF OPTOMETRY, P.C.
- Practice address
- 15 W Franklin St
Liberty, MO 64068-1636 - Phone
- (816) 781-2100
- Fax
- (816) 781-2106
- NPI assigned
- Feb 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Ann C Waterman, O.D.
- Title
- President Corp, Optometrist
- Phone
- (816) 781-2100
Practitioners 3
-
Alex Baker, OD
-
Ann Chapman Waterman, O.D.
-
Daniel H Jones, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041116000821 | MO | Part B Supplier - Clinic/Group Practice | 1951364553 |
Receives reassigned benefits from 2 practitioners Practice locations: Liberty, MO |
National Provider Directory
Locations
15 W Franklin St
Liberty, MO 64068
Phone (816) 781-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2003015398 | MO | |
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
15 W Franklin St
Liberty, MO 64068-1636
Mailing address
15 W Franklin St
Liberty, MO 64068-1636
Phone (816) 781-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC3193 | Other | MEDICARE RAILROAD GROUP # | |
| 34970014 | Other | MO | BCBSKC GROUP # |
Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.