Brian Keith Waters, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR008092 Issued in GA

Practice address

403 Ward St W
Douglas, GA 31533-3505

Phone

(912) 260-0005

NPI assigned

Jul 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Blue Waters Wellness LLC

  • Chiropractor
  • Douglas, GA
  • NPI 1134737778
  NPD Authorized official
• South Georgia Chiropractic

  • Chiropractor
  • Baxley, GA
  • NPI 1275932493
  NPD (past)

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1851944607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6257 OLD AXSON RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315353429",
            "telephone_number": "912-314-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 WARD ST W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333505",
            "telephone_number": "912-260-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Culpepper Walker, RN277971
• Kathryn Walker, PHARMD
• Meagan Louise Walker, PHARMACIST
• Wallace Steve Anderson DO, PC
• Ware Visiting Nurses Service, Inc
• Tequasia Watts
• Julie Weaver, RDH
• Jeffrey Philip Weems, ATC
• Kristy A Weems, PT
• Westside Drug Inc

• Chiropractor in Douglas, GA
• Providers in Douglas, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.