Individual provider Active NPI

Louise C Waszak, PHD, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1710964093
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9322769 Issued in FL
Practice address
4520 W US Highway 90
Lake City, FL 32055-8341
Phone
(386) 719-3939
NPI assigned
Dec 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP 009371 PA
Family Nurse Practitioner 363LF0000X AP30008047 WA
Family Nurse Practitioner 363LF0000X ARNP 9322769 FL Primary
Pediatric Nurse Practitioner 363LP0200X SP002220D PA
Medical-Surgical Clinical Nurse Specialist 364SM0705X AP30008047 WA

Addresses

Primary practice location

4520 W US Highway 90
Lake City, FL 32055-8341

Mailing address

525 Turkey Creek
Alachua, FL 32615
Phone (386) 462-9907

Other identifiers 8

IdentifierTypeStateIssuer
230417OtherL&I
9655978MedicaidWA
G8871962OtherWANEW MEDICARE SNO. CO
8946801OtherCRIME VICTIMS
G8871961OtherWANEW MEDICARE KING CO
0211088-06OtherMDANCC PNP CERT
2006009683OtherMDANCC FNP CERT
20060018OtherMDPNCB AC-PNP CERT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ARNP 9322769FLMDFamily Nurse Practitioner
SP 009371PAMDFamily Nurse Practitioner
AP30008047WAMDFamily Nurse Practitioner
SP002220DPAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Nov 16, 2012 Accepting new patients
E Plus Florida Comprehensive Cancer Care, LLC PastSince Aug 4, 2003 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

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.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1710964093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 TURKEY CREEK",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "32615",
            "telephone_number": "386-462-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 W US HIGHWAY 90",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558341",
            "telephone_number": "386-719-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASZAK",
        "first_name": "LOUISE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD, ARNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP 009371",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30008047",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9322769",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP002220D",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "WA",
            "license": "AP30008047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "230417",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9655978",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEDICARE SNO. CO",
            "identifier": "G8871962",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8946801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEDICARE KING CO",
            "identifier": "G8871961",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC PNP CERT",
            "identifier": "0211088-06",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC FNP CERT",
            "identifier": "2006009683",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PNCB AC-PNP CERT",
            "identifier": "20060018",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.