Amanda Anne Waters, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11008044 Issued in FL

Practice address

455 Emerald Ave
Lake Wales, FL 33853-4716

Phone

(863) 687-1472

Fax

(863) 687-1494

NPI assigned

Jul 1, 2020

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awaters53150@lrhs.direct-ci.com
• Direct secure messaging: tlcfamilypractice.amandaawaters@120233.advancedmd-direct.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.

• Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
  • NPI 1497748743
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Polk South Inc

  • General Acute Care Hospital
  • Lake Wales, FL
  • NPI 1053972760
  Care Compare affiliation

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1659998102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 WILDWOOD CT",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843000",
            "telephone_number": "863-837-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 EMERALD AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534716",
            "telephone_number": "863-687-1472",
            "fax_number": "863-687-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "AMANDA",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreens
• Heather Wardy
• Wendy Warman, SLP
• Adeline Brooke Warren
• We Elderly Care Inc
• Ralph Edward Weaver III, ARNP-BC
• Webb Counseling, LLC
• Rosemary T Webb, LMHC
• Mary Lyon Weisfeld, CRNA

• Family Nurse Practitioner in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.