Erica Ann Waddle, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0102204292 Issued in VA

Practice address

4000 Wellness Dr
Midland, MI 48670

Phone

(989) 839-1644

Fax

(989) 839-3029

NPI assigned

May 22, 2013

Last updated

Nov 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in VA

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

Specialty

Internal Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kingsford Physician Services LLCGroup PAC ID 0840541017, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Hospital Pulaski Hospital, Pulaski, VA, CCN 490116
• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
• Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110

Merit-based Incentive Payment System (MIPS)

Final score

93.99 of 100Reported as group

Quality

77.03

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kingsford Physician Services, LLC

  • Hospitalist Physician
  • Pulaski, VA
  • NPI 1871088526
  Medicare reassignment Care Compare group NPD
• Ingleside Physician Services, LLC

  • Hospitalist Physician
  • Low Moor, VA
  • NPI 1932693488
  Medicare reassignment NPD
• Lake Spring Physician Services, LLC

  • Hospitalist Physician
  • Salem, VA
  • NPI 1568954287
  Medicare reassignment NPD
• Southeastern Intensivist Services PC

  • Hospitalist Physician
  • West Memphis, AR
  • NPI 1912942665

  Internal Medicine, VA

  Medicare reassignment NPD
• Wildwood Physician Services, LLC

  • Emergency Medicine Physician
  • Blacksburg, VA
  • NPI 1629560917
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lewis-Gale Medical Center, LLC

  dba Lewisgale Medical Center

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation
• Montgomery Regional Hospital Inc

  dba Lewisgale Hospital Montgomery

  • General Acute Care Hospital
  • Blacksburg, VA
  • NPI 1275570376
  Care Compare affiliation
• Pulaski Community Hospital Inc

  dba Lewisgale Hospital Pulaski

  • General Acute Care Hospital
  • Pulaski, VA
  • NPI 1205882396
  Care Compare affiliation
• Pulaski Community Hospital, Inc.

  dba LewisGale Hospital Pulaski

  • Psychiatric Hospital Unit
  • Pulaski, VA
  • NPI 1477018893
  Care Compare affiliation

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1730526393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-1644",
            "fax_number": "989-839-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48670",
            "telephone_number": "989-839-1644",
            "fax_number": "989-839-3029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 S Main St",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240607017",
            "country_code": "US",
            "telephone_number": "919-270-8394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Lee Hwy N",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "VA",
            "postal_code": "243012326",
            "country_code": "US",
            "telephone_number": "540-994-8100",
            "fax_number": "540-994-8494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Wellness Dr",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "48670",
            "country_code": "US",
            "telephone_number": "989-839-1644",
            "fax_number": "989-839-3029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADDLE",
        "first_name": "ERICA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102204292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5101024372",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Graham Vonfintel I
• Riley Ann Voss
• Michelle Vouaux
• Jodi Wachowiak
• Bryce Wackerle
• Della Wade, MSW
• Kenton Wadsworth, DACM, LAC
• Andrew Standish Wagner, MD
• Autum T Wainwright
• Janet Lee Wakeman, PTA

• Internal Medicine Physician in Midland, MI
• Providers in Midland, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.