Lynn Michael Waters Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS10513 Issued in FL

Practice address

3839 County Road 218
Middleburg, FL 32068-5708

Phone

(904) 282-5474

Fax

(904) 282-5824

NPI assigned

Sep 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL, GA2 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

Specialty

Osteopathic Manipulative Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Philadelphia College of Osteopathic MedicineGroup PAC ID 0648179234, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lynn.waters.p1@direct.pcom.nextgenshare.com

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.

• Philadelphia College of Osteopathic Medicine

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1881635704

  GA

  Medicare reassignment Care Compare group NPD
• Physicians Group Services PA

  dba Coastal Health

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1861440810
  Medicare reassignment NPD
• Solantic of Jacksonville, LLC

  dba CareSpot Express Healthcare

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100

  Family Medicine

  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1326208695
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1487814752
  Medicare reassignment NPD
• Physicians Group Services PA

  dba Coastal Health

  • Family Medicine Physician
  • Fleming Island, FL
  • NPI 1699138362
  NPD
• Physicians Group Services PA

  dba Coastal Health

  • Durable Medical Equipment & Medical Supplies
  • Middleburg, FL
  • NPI 1699170035
  NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  Family Medicine

  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Memorial Family Practice Associates, LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1598869844
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1487840633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "904-282-6331",
            "fax_number": "904-619-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 COUNTY ROAD 218",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320685708",
            "telephone_number": "904-282-5474",
            "fax_number": "904-282-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "LYNN",
        "middle_name": "MICHAEL",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1488L",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002290100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003126257A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #06744)
• Walker's Transportation LLC
• Michelle Lejeune Walton, APRN
• Morgan Cheyenne Ware, LMT
• Rebekah Anne Warren, RRT
• Tracy N Watford
• Andrew Welch
• Katherine Wenger, DPT
• David W Westcott, LMHC
• Deborah Anne Weyer, MD

• Family Medicine Physician in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.