Active NPI
Bruce Allan Waterman, M.D.
- Adult Medicine Physician
- Pensacola, FL
National Provider Identifier
1689601361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- MD00037272
- Practice address
- Nmotc
220 Hovey Rd
Pensacola, FL 32508 - Phone
- (850) 452-9484
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00037272 | WA | |
| Adult Medicine Physician | 207QA0505X | MD00037272 | WA | Primary |
Addresses
Primary practice location
Nmotc
220 Hovey Rd
Pensacola, FL 32508
Mailing address
505 S. 336TH St.
Suite 600
Federal Way, WA 98003
Phone (253) 838-6180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00037272 | WA | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Physician Associates, Apc | Emergency Medicine | Past | Accepting new patients |
| Emergency Physicians PC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Chattanooga, TN
- NPI 1912955360
-
- Emergency Medicine Physician
- Federal Way, WA
- NPI 1407127442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1689601361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S. 336TH ST.",
"address_2": "SUITE 600",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98003",
"telephone_number": "253-838-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NMOTC",
"address_2": "220 HOVEY RD",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "32508",
"telephone_number": "850-452-9484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERMAN",
"first_name": "BRUCE",
"middle_name": "ALLAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD00037272",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "WA",
"license": "MD00037272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.