Individual provider Active NPI

Stephen Waite, M.D.

  • Emergency Medicine Physician
  • Fort Stewart, GA
National Provider Identifier
1487720348
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10553 Issued in HI
Practice address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone
(912) 435-6965
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 10553 HI Primary

Addresses

Primary practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MP2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050303000946 TX Practitioner - Emergency Medicine 8729071733 Reassigns benefits to 2 organizations
I20230801000679 MP Practitioner - Emergency Medicine 8729071733 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10553HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince May 21, 2020 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Dec 22, 2013 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Jun 10, 2023 Accepting new patients
Commonwealth Healthcare Corporation Current Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Jun 10, 2023 Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients
Riverside Radiation Oncology Inc Past Accepting new patients
Oscar Nicholson Jr MD Inc Past Accepting new patients
Mid-Ohio Emergency Services, LLC Emergency Medicine Past Accepting new patients
Knox Emergency Services, LLC Emergency Medicine Past Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1487720348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "10553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

Verify at the official NPI Registry.