Nancy Kaye Waite-O'Brien, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4037 Issued in TN

Practice address

423 E McKinney Ave
Rogersville, TN 37857-3339

Phone

(760) 275-8598

Fax

(423) 500-0119

NPI assigned

Mar 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Wind Horse Crossing PLLC

  • Community/Behavioral Health Agency
  • Rogersville, TN
  • NPI 1982435301
  Medicare reassignment NPD Authorized official
• Adam Farzaneh MD PC

  • Family Medicine Physician
  • Rancho Mirage, CA
  • NPI 1669246898
  NPD (past)
• Eisenhower Medical Center

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  NPD (past)

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1528450384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 E MCKINNEY AVE",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378573339",
            "telephone_number": "760-275-8598",
            "fax_number": "423-500-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 E MCKINNEY AVE",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378573339",
            "telephone_number": "760-275-8598",
            "fax_number": "423-500-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE-O'BRIEN",
        "first_name": "NANCY",
        "middle_name": "KAYE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY13350",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "4037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith A Vaughn, PT
• Susan Frances Venable, RN
• Cecilia A Verzosa, PT
• John Anthony Vincenzo, LPN
• Vision Healthcare Solutions LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Leigh Andrea Walters, BA
• Randall Paul Weaver, MSW LCSW 3920

• Clinical Psychologist in Rogersville, TN
• Providers in Rogersville, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.