McKinley Jackson Waugh, DNP, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

34655 Issued in TN

Practice address

900 E 3Rd St
Chattanooga, TN 37403-2101

Phone

(423) 778-5910

NPI assigned

Nov 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. McKinley Suzanne Jackson Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Erlanger Health

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1477256303
  Medicare reassignment NPD
• Erlanger Health

  • Durable Medical Equipment & Medical Supplies
  • Chattanooga, TN
  • NPI 1740073329
  NPD
• Chattanooga Hamilton County Hospital Authority

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1154751931
  NPD (past)

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1760255681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 NEYLAND CIR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373436901",
            "telephone_number": "706-691-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032101",
            "telephone_number": "423-778-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "MCKINLEY",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "DNP, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TN",
            "license": "233323",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "34655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKINLEY",
            "last_name": "JACKSON",
            "middle_name": "SUZANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mattie Watson
• Meghan Watson
• Stacye E Watson, NP-C
• Jana S. Watters, N.P.
• Jeffrey Watts, R.N.
• Wave Physical Therapy, Incorporated
• Waves Wellness & Counseling Services LLC
• Chala Wayu
• We Go Transportation LLC
• Emma J Weatherbee

• Pediatric Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.

Verify at the official NPI Registry.