James M Waldeck, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

14006 Issued in WV

Practice address

1600 Medical Center Dr Ste 3500
Huntington, WV 25701-3655

Phone

(304) 691-1300

Fax

(304) 691-1375

NPI assigned

Apr 17, 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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• University Physicians & Surgeons, Inc

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1730183286
  Medicare reassignment NPD
• University Physicians & Surgeons, Inc.

  • Health & Wellness Coach
  • Louisa, KY
  • NPI 1073256665
  NPD
• Cabell Huntington Hospital Inc

  dba Cabell Huntington Hospital

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1073518007
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1760446637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013655",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDECK",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WV",
            "license": "14006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0752172",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112996000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64698301",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.waldeck@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr Ste 3500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick Wagner
• Xavier Wagner
• Colin John Wakeman, ATC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2244)
• Wal-Mart Stores East, LP (Vision Center 30-2244)
• Kate M. Waldeck, MD
• Walgreen Co (Walgreens #18324)
• Walgreen Co (Walgreens #17117)
• Walgreen Co. (Walgreens #11980)
• Walgreen Co. (Walgreens #11980)

• Pediatric Critical Care Medicine Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Pediatric Critical Care Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.