Jennifer Haley Waddle, WHCNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

AP04789 Issued in LA

Practice address

2508 Bert Koun Loop
Suite 201
Shreveport, LA 71118-3133

Phone

(318) 212-5790

Fax

(318) 212-5795

NPI assigned

May 9, 2007

Last updated

Apr 13, 2016By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Womens Health ClinicGroup PAC ID 4981772175, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwaddle1@direct.wkhs.com

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.

• WK Womens Health Clinic

  • Obstetrics & Gynecology Physician
  • Shreveport, LA
  • NPI 1124283320
  Medicare reassignment Care Compare group NPD
• Women's Health Center, Apmc

  • Specialist
  • Alexandria, LA
  • NPI 1790869295
  NPD (past)

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

• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1366656787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUN LOOP",
            "address_2": "SUITE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183133",
            "telephone_number": "318-212-5790",
            "fax_number": "318-212-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUN LOOP",
            "address_2": "SUITE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183133",
            "telephone_number": "318-212-5790",
            "fax_number": "318-212-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDLE",
        "first_name": "JENNIFER",
        "middle_name": "HALEY",
        "name_prefix": "Mrs.",
        "credential": "WHCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "LA",
            "license": "AP04789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "AP04789",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE---NURSING",
            "identifier": "RN098243",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• W. J. Dudley Denture Consultants (professional denture clinic)
• W. Ronald Skowsky, MD. LLC.
• Comis Waddell
• David D Waddell, MD
• Raina Waddell
• Deborah J Wade, R.PH.
• Jacob Daniel Wade
• Latisha Wadley
• James Michael Wages Jr., M.D.
• Gabrielle Renee Waggoner

• Women's Health Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Women's Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.
• 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.