Mandy Lynne Waters, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R 0073536 Issued in OK

Practice address

721 Better Now PLZ
Ada, OK 74820-2279

Phone

(580) 272-0025

NPI assigned

Jun 17, 2016

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gary L Paddack, MD

  • Internal Medicine Physician
  • Ada, OK
  • NPI 1053389833
  Medicare reassignment
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1619327970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 ARLINGTON CTR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202883",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-272-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MANDY",
        "middle_name": "LYNNE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R 0073536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "550021ZHJP",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tarra Ward
• Paul Franklin Warlick, D.O.
• Kristen Warnock, D.O.
• Clay Warren
• Jaycee Warren
• Christyn Kay Wear, MSW
• Jana Jean Webb, LPC
• Nathan Wade Weeks, BA
• Mark Winfield Weems, D.D.S.
• Ruth Ann Weesner, MD

• Family Nurse Practitioner in Ada, OK
• Providers in Ada, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.