Active NPI
Victor Owen Waters, M.D.
- Emergency Medicine Physician
- Skiatook, OK
National Provider Identifier
1376769422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 17315
- Practice address
- 120 South 'B' Street
Skiatook, OK 74070-1539 - Phone
- (918) 230-2193
- Fax
- (918) 396-7319
- NPI assigned
- Apr 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 17315 | CO | |
| Anesthesiology Physician | 207L00000X | 9275 | OK | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 9275 | OK | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 17315 | CO | |
| Emergency Medicine Physician | 207P00000X | 9275 | OK | |
| Emergency Medicine Physician | 207P00000X | 17315 | CO | Primary |
Addresses
Primary practice location
120 South 'B' Street
Skiatook, OK 74070-1539
Mailing address
120 South 'B' Street
Skiatook, OK 74070-1539
Phone (918) 230-2193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17315 | CO | MD | Critical Care Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1376769422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 SOUTH 'B' STREET",
"city": "SKIATOOK",
"state": "OK",
"postal_code": "740701539",
"telephone_number": "918-230-2193",
"fax_number": "918-396-7319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SOUTH 'B' STREET",
"city": "SKIATOOK",
"state": "OK",
"postal_code": "740701539",
"telephone_number": "918-230-2193",
"fax_number": "918-396-7319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "VICTOR",
"middle_name": "OWEN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CO",
"license": "17315",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OK",
"license": "9275",
"primary": false
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "OK",
"license": "9275",
"primary": false
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "CO",
"license": "17315",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OK",
"license": "9275",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "17315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skiatook, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.