David Waddell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101042669 Issued in VA

Practice address

1856 Colonial Medical CT
Suite a
Virginia Beach, VA 23454-3075

Phone

(757) 962-6262

Fax

(757) 962-1185

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: david.waddell@142175237439492.direct.elationemr.com

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1710996491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 COLONIAL MEDICAL CT",
            "address_2": "SUITE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543075",
            "telephone_number": "757-962-6262",
            "fax_number": "757-962-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 COLONIAL MEDICAL CT",
            "address_2": "SUITE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543075",
            "telephone_number": "757-962-6262",
            "fax_number": "757-962-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101042669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5640989",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George N Vretakis, MD
• Michael Vuiller, D.C.
• Anthony J. Vuolo Jr., DPM
• Priyam Kirit Vyas
• Elizabeth Vyvlecka
• Mary Elizabeth Wade Diaz, DO
• Carol Jutras Wade, CRNA
• Crystal Lynn Wade
• Heather Ann Wade
• Ronda Wade

• Family Medicine Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.

Verify at the official NPI Registry.