Alissa C Waters

Primary specialty

Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X

License

1566-403 Issued in WI

Practice address

3230 University Ave Ste 12
Madison, WI 53705-3540

Phone

(608) 285-5645

NPI assigned

Mar 31, 2017

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Shade Medical and Creative Tattoo LLC

  • Medical Art Specialist/Technologist
  • Madison, WI
  • NPI 1548820731

  Art, Medical

  NPD Authorized official

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1730611468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 UNIVERSITY AVE STE 12",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053540",
            "telephone_number": "608-571-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 UNIVERSITY AVE STE 12",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053540",
            "telephone_number": "608-285-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ALISSA",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": "WI",
            "license": "1566-403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Washington
• Water Tiger Psychotherapy, LLC
• Julie M Waterdu, LMFT
• Robert William Waterman Jr., MD
• Alexis M Waters, PA-C
• Anna L Waters, MS, CCC-SLP
• Christiane Waters, NP
• Gary E Waters, MD
• Katelyn Watkin, LCGC
• Brooklynne M Watkins, PA

• Medical Art Specialist/Technologist in Madison, WI
• Providers in Madison, WI by specialty
• Medical Art Specialist/Technologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.