Active NPI
David Charles Waterson Jr., PA-C
- Physician Assistant
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601010609
- Practice address
- 2902 Bradford St NE
Grand Rapids, MI 49525-6427 - Phone
- (616) 885-5200
- NPI assigned
- Jun 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601010609 | MI | Primary |
Addresses
Primary practice location
2902 Bradford St NE
Grand Rapids, MI 49525-6427
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dwaterson3379065@epic00.corewelldirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
1845 Holton Rd
Muskegon, MI 49445-1531
Phone (616) 885-5000
2900 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 885-5000
2902 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 486-6577
330 Barclay Ave NE
200 Corewell Health Medical Group West
Grand Rapids, MI 49503-2525
Phone (616) 391-2802
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
601 John St
Kalamazoo, MI 49007-5377
601 John St
Suite 100
Kalamazoo, MI 49007-5317
Phone (269) 373-1222
6105 Wilson Ave SW
Wyoming, MI 49418-9714
6105 Wilson Ave SW FL
2 Corewell Health Medical Group West
Wyoming, MI 49418-9714
Phone (616) 267-8950
Hospital & facility affiliations
- Spectrum Health
- Bronson Methodist Hospital
- Corewell Health Gerber Hospital
- Trinity Health Muskegon Hospital
- Bronson Lakeview Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.43 of 100
- Quality
- 75.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.38
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Bronson Methodist Hospital | Physician Assistant | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients |
Locations
2902 Bradford St NE
Grand Rapids, MI 49525
Phone (616) 486-6550
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Nurse Practitioner
- Grand Rapids, MI
- NPI 1346480258
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Paw Paw, MI
- NPI 1962508259
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1831116441
-
- General Acute Care Hospital
- Muskegon, MI
- NPI 1831132133
-
- Critical Access Hospital
- Fremont, MI
- NPI 1063836963
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1821666876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2902 BRADFORD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256427",
"telephone_number": "616-885-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERSON",
"first_name": "DAVID",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-16",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601010609",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dwaterson3379065@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "2902 Bradford St NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495256427",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "2902 Bradford St NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495256427",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.