Active NPI
Louise C Waszak, PHD, ARNP, FNP-BC
- Family Nurse Practitioner
- Lake City, FL
National Provider Identifier
1710964093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP 9322769
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230417 | Other | L&I | |
| 9655978 | Medicaid | WA | |
| G8871962 | Other | WA | NEW MEDICARE SNO. CO |
| 8946801 | Other | CRIME VICTIMS | |
| G8871961 | Other | WA | NEW MEDICARE KING CO |
| 0211088-06 | Other | MD | ANCC PNP CERT |
| 2006009683 | Other | MD | ANCC FNP CERT |
| 20060018 | Other | MD | PNCB 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 9322769 | FL | MD | Family Nurse Practitioner |
| SP 009371 | PA | MD | Family Nurse Practitioner |
| AP30008047 | WA | MD | Family Nurse Practitioner |
| SP002220D | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic LLC | Family | Current | Accepting new patients |
| E Plus Florida Comprehensive Cancer Care, LLC | Past | 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.
-
- Family Nurse Practitioner
- Rockville, MD
- NPI 1134191836
-
dba Community Cancer Center of North Florida
- Hematology & Oncology Physician
- Gainesville, FL
- NPI 1831116276
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.