Waterford Medical Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

038600 Issued in GA

Legal business name

WATERFORD MEDICAL CLINIC

Practice address

3069 Amwiler Rd
Suite Two
Atlanta, GA 30360-2825

Phone

(678) 969-9920

Fax

(678) 969-9919

NPI assigned

Dec 30, 2011

Organization subpart

No

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

Authorized official

Name

Dr. John Salinas

Title

Medical Director

Phone

(404) 992-9130

Specialties & licenses 1

Addresses

Tax ID family

Aaa Waterford Medical Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Aaa Waterford Medical Clinic, LLC

  • Clinic/Center
  • Atlanta, GA
  • NPI 1366711202
  NPD tax ID

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325203200000",
    "number": "1366712846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3069 AMWILER RD",
            "address_2": "SUITE 2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602825",
            "telephone_number": "678-969-9920",
            "fax_number": "678-969-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3069 AMWILER RD",
            "address_2": "SUITE TWO",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602825",
            "telephone_number": "678-969-9920",
            "fax_number": "678-969-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFORD MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A",
        "authorized_official_last_name": "SALINAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-992-9130",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": "038600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haimanot Wasse, MD, MPH
• Caroline Smith Wasserman
• Jessica L Wasserman, NP
• Nathan Aaron Wasserman, MD
• Affan Wasti
• Mark B. Waterman, M.D.
• Watermark Medical, Inc.
• Alyssa Waters, OTD, OTR/L
• Brittany Waters, DMD
• Chiyyia Nycole Waters

• General Practice Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.