Bruce Kevin Waite, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

62771 Issued in MN

Practice address

1000 First Dr NW
Austin, MN 55912-2941

Phone

(507) 433-7351

Fax

(507) 668-2975

NPI assigned

May 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Samaritan Pacific Health Services, Inc

  dba Samaritan Kidney Specialists - Newport

  • Rural Health Clinic/Center
  • Depoe Bay, OR
  • NPI 1164781142
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851394530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W. FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384",
            "fax_number": "507-668-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FIRST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351",
            "fax_number": "507-668-2975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Fairview Ave",
            "address_2": "Suite 229",
            "address_purpose": "LOCATION",
            "city": "Skowhegan",
            "state": "ME",
            "postal_code": "049761481",
            "country_code": "US",
            "telephone_number": "207-474-7131",
            "fax_number": "207-474-3998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAITE",
        "first_name": "BRUCE",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ME",
            "license": "DO1972",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "DO17052",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "62771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025226",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vop South Grove Lodge, LLC (South Grove Lodge Senior Living)
• Akaylah Maire Vue
• Mark Wachlin, LADC
• Gary Allen Wagenaar, MS LADC
• Jill Marie Wagner, MS
• Wal-Mart Stores, Inc. (Walmart Vision CEnter 30-4257)
• Walgreen Co (Walgreens #09094)
• Walleye Dental LLC
• Katherine Wallin, LICSW
• Walmart Inc. (Walmart Pharmacy 10-4257)

• Obstetrics & Gynecology Physician in Austin, MN
• Providers in Austin, MN by specialty
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.