Kimbra Waters

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

PHCP011148 Issued in GA

Practice address

340 Eisenhower Dr Ste 520
Savannah, GA 31406-1617

Phone

(912) 999-7833

Fax

(912) 999-7838

NPI assigned

Sep 22, 2021

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

State licenses

Practice roles

Locations

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.

• Autumn of Life Home Care LLC

  • In Home Supportive Care Agency
  • Savannah, GA
  • NPI 1528714821
  NPD Authorized official

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1447921101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR STE 520",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061617",
            "telephone_number": "912-999-7833",
            "fax_number": "912-999-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR STE 520",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061617",
            "telephone_number": "912-999-7833",
            "fax_number": "912-999-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KIMBRA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "PHCP011148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheema Washington, NP
• Vondell Washington
• Water'S Edge Counseling
• Donihue Waters, DDS MDS
• Jodi Waters, RN
• Daniel Watkins, LMFT, LPC, MAC
• Jada Unique Watkins, PN
• Shantaniqua Watkins, RBT
• George Watmore
• Amber S Watson

• Home Health Agency in Savannah, GA
• Providers in Savannah, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.