Kobena Y Waters, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

97289 Issued in GA

Practice address

5305 Country Lake CT SW
Lilburn, GA 30047-6760

Phone

(301) 651-2211

NPI assigned

Apr 24, 2018

Sex

Male

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Chronic Disease Management of Georgia, LLC

  • Physical Medicine & Rehabilitation Physician
  • Monroe, GA
  • NPI 1699300939
  Medicare reassignment NPD
• Georgia Mso LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1952196164
  Medicare reassignment NPD
• Hardy Renew Wellness,LLC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1952914368
  Medicare reassignment NPD
• Transitional Care Physicians of Georgia PC

  • Specialist
  • Monroe, GA
  • NPI 1619317542
  NPD (past)
• Tucker Operating Company LLC

  • Skilled Nursing Facility
  • Tucker, GA
  • NPI 1700563905
  NPD (past)
• Universe Cypress LLC

  • Skilled Nursing Facility
  • Athens, GA
  • NPI 1497176465
  NPD (past)

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1699263848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 COUNTRY LAKE CT SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 COUNTRY LAKE CT SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476760",
            "telephone_number": "301-651-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KOBENA",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "97289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minsheng Wang, M.D
• Elizabeth Ward, ATC
• Warm Hearts Home Care Services LLC
• Felicity M. Warren, M.D.
• Tia L Warren, LCSW
• Christina M Watts, D.A.
• Karla Jenae Waugh
• Ashari N Webb, RBT
• Brandon Montez Webb, LCSW
• Elvira P Weekes, RN

• Internal Medicine Physician in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.