NPIMap

Individual provider Active NPI

Dan Neal Waters, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1750341012
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14804 Issued in OK
Practice address
5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone
(405) 557-1200
Fax
(405) 557-1977
NPI assigned
Mar 23, 2006
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14804 OK Primary

Addresses

Primary practice location

5721 NW 132ND St
Oklahoma City, OK 73142-4437

Mailing address

5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone (405) 557-1200

Other identifiers 1

IdentifierTypeStateIssuer
10019480BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040515000042 OK Practitioner - Family PracticePractitioner - Emergency Medicine 1850381443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Term Care Specialists, IncGroup PAC ID 3476550740, 37 clinicians

Practice addresses (Care Compare)

3233 NW 10 St
GLC NW
Oklahoma City, OK 73107-5203
Phone (405) 943-8366

5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone (405) 557-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14804OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Term Care Specialists, Inc CurrentSince May 16, 2006 Accepting new patients
Careconnectmd Oklahoma PC CurrentSince Jan 1, 2025 Accepting new patients
Value Based Long Term Care J PC CurrentSince May 13, 2025 Accepting new patients
Parkland Manor Living Center LLC Past Accepting new patients
Sooner Geriatrics, LLC Past Accepting new patients
Glenpool Operations LLC Past Accepting new patients
Jenks Living Centers LLC Past Accepting new patients
Lightstar Emergency Physicians, PLLC Past Accepting new patients
Chandler Therapy & Living Center LLC Past Accepting new patients
GGP, LLC Past Accepting new patients
University Northwest, LLC Past Accepting new patients
Southwest LTC - NW Okc, LLC Past Accepting new patients
Morningstar Emergency Physicians PLLC Past Accepting new patients
Wolfe Living Center Association Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

101 Park Ave
Ste 1300
Oklahoma City, OK 73102
Phone (405) 689-9820

2801 NW 61st St
Oklahoma City, OK 73112
Phone (405) 842-6601

3233 NW 10th St
Oklahoma City, OK 73107
Phone (405) 943-8366

4334 NW Expressway
Ste 175
Oklahoma City, OK 73116
Phone (405) 557-1200

5721 NW 132nd St
Oklahoma City, OK 73142
Phone (405) 557-1200

8900 Silver Hill Dr
Oklahoma City, OK 73132
Phone (405) 557-1200

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Wolfe Living Center at Summit RidgeHarrah, OK, CCN 375472 Skilled nursing facility Adp of the SNF Apr 29, 2025
Gran Grans PlaceYukon, OK, CCN 375410 Skilled nursing facility Adp of the SNF Jun 3, 2025
Good Shepherd HospiceOklahoma City, OK, CCN 371538 Hospice Contracted Managing Employee Jun 20, 2006

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1750341012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5721 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "405-557-1200",
            "fax_number": "405-557-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "405-557-1200",
            "fax_number": "405-557-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "DAN",
        "middle_name": "NEAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "14804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10019480B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.