Individual provider Active NPI

Waden Everett Emery III, MD

  • Neurology Physician
  • Lighthouse Point, FL
National Provider Identifier
1831154319
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME45215 Issued in FL
Practice address
5340 N Federal Hwy
Suite 205
Lighthouse Point, FL 33064-7058
Phone
(954) 771-8300
Fax
(954) 771-4002
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME45215 FL Primary

Addresses

Primary practice location

5340 N Federal Hwy
Suite 205
Lighthouse Point, FL 33064-7058

Mailing address

5340 N Federal Hwy
Suite 205
Lighthouse Point, FL 33064-7058
Phone (954) 771-8300

Other identifiers 1

IdentifierTypeStateIssuer
049128400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20080515000188 FL Practitioner - NeurologyPractitioner - General PracticePractitioner - Family PracticePractitioner - Physical Medicine and RehabilitationPractitioner - PsychiatryPractitioner - Critical Care (Intensivists)Practitioner - Neuropsychiatry 1658440755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Critical Care (Intensivists), Family Practice, General Practice, Neuropsychiatry
Education
Washington University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Lighthouse Point, FL 33064
Phone (954) 224-5062

Hospital & facility affiliations

  • Broward Health North Hospital, Deerfield Beach, FL, CCN 100086
  • Broward Health Imperial Point Hospital, Fort Lauderdale, FL, CCN 100200
  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME45215FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joyce E Newcomb, PHD, RN, PA PastSince Mar 11, 2008 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1831154319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 N FEDERAL HWY",
            "address_2": "SUITE 205",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647058",
            "telephone_number": "954-771-8300",
            "fax_number": "954-771-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 N FEDERAL HWY",
            "address_2": "SUITE 205",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647058",
            "telephone_number": "954-771-8300",
            "fax_number": "954-771-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERY",
        "first_name": "WADEN",
        "middle_name": "EVERETT",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME45215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049128400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

Verify at the official NPI Registry.