Emanuel Montez Waddell

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024191239 Issued in VA

Practice address

109 Railroad Ave
Wakefield, VA 23888-0097

Phone

(757) 312-8730

Fax

(757) 510-9326

NPI assigned

Jul 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Uniformed Services Uhs Fe Hebert School of Med, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Home Care Services-Suffolk Home health agency, Suffolk, VA, CCN 497746
• At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
• Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
• Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  VA

  Medicare reassignment NPD

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

• Advanced Technologies in Home Care, Inc.

  • Home Health Agency
  • Richmond, VA
  • NPI 1376509430
  Care Compare affiliation
• Bon Secours Mercy Health Petersburg LLC

  • General Acute Care Hospital
  • Petersburg, VA
  • NPI 1720623853
  Care Compare affiliation
• Sentara Enterprises

  • Home Health Agency
  • Suffolk, VA
  • NPI 1174060214
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Suffolk, VA
  • NPI 1376540138
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1760835342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RAILROAD AVE",
            "city": "WAKEFIELD",
            "state": "VA",
            "postal_code": "23888",
            "telephone_number": "757-312-8730",
            "fax_number": "757-510-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 RAILROAD AVE",
            "city": "WAKEFIELD",
            "state": "VA",
            "postal_code": "238880097",
            "telephone_number": "757-312-8730",
            "fax_number": "757-510-9326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Nider Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234598701",
            "country_code": "US",
            "telephone_number": "757-953-8244",
            "fax_number": "757-953-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "EMANUEL",
        "middle_name": "MONTEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "790297",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138266",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024191239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa V Hawkins
• Jennifer Clark Jones, CERTIFIED HAIR LOSS
• Obici Medical Management Services, Inc.
• Sharon Dale Rogers, PH.D., ATC
• Sentara Medical Group
• Wakefield Pharmacy Inc
• Carrie S Wiggins, FNPC

• Family Nurse Practitioner in Wakefield, VA
• Providers in Wakefield, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.