Organization Active NPI

J. Waterman & Associates, LLC

  • Nephrology Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1487158929
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS5237
Legal business name
J. WATERMAN & ASSOCIATES, LLC
Practice address
2543 Burns Rd
Palm Beach Gardens, FL 33410-5204
Phone
(561) 308-8086
NPI assigned
Mar 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Authorized official

Name
Vicki Waterman
Title
Administrator
Phone
(561) 308-8086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X OS5237 Primary

Addresses

Primary practice location

2543 Burns Rd
Palm Beach Gardens, FL 33410-5204

Mailing address

729 Charlestown Cir
Palm Beach Gardens, FL 33410-3428

Other identifiers 1

IdentifierTypeStateIssuer
045840600MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1487158929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 CHARLESTOWN CIR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103428",
            "fax_number": "561-622-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2543 BURNS RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334105204",
            "telephone_number": "561-308-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. WATERMAN & ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-308-8086"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": "OS5237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045840600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.