Individual provider Active NPI

Jean L Waters, CFNP

  • Family Nurse Practitioner
  • Harrisonburg, VA
National Provider Identifier
1669448486
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167672 Issued in VA
Practice address
1931 Medical Ave
Harrisonburg, VA 22801-3437
Phone
(540) 689-5600
Fax
(540) 689-5601
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024167672 VA Primary

Addresses

Primary practice location

1931 Medical Ave
Harrisonburg, VA 22801-3437

Mailing address

PO Box 1430
Harrisonburg, VA 22803-1430
Phone (540) 564-5600

Other identifiers 1

IdentifierTypeStateIssuer
1669448486MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20081001000714 VA Practitioner - Nurse Practitioner 1254347321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saunders and Peavy LLCGroup PAC ID 1153710017, 9 clinicians

Practice addresses (Care Compare)

182 Neff Ave
Suite W12
Harrisonburg, VA 22801-3488

343 Neff Ave
Suite C
Harrisonburg, VA 22801-3683
Phone (540) 432-9996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024167672VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saunders & Peavy LLC CurrentSince Feb 10, 2023 Accepting new patients

Locations

182 Neff Ave
Ste W12
Harrisonburg, VA 22801
Phone (540) 432-9996

343 Neff Ave
Ste C
Harrisonburg, VA 22801
Phone (540) 432-9996

Organizations & group practices 1

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1669448486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228031430",
            "telephone_number": "540-564-5600",
            "fax_number": "540-564-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 MEDICAL AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013437",
            "telephone_number": "540-689-5600",
            "fax_number": "540-689-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JEAN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669448486",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.