NPIMap

Individual provider Active NPI

Mark Waweru, M.D.

  • Family Medicine Physician
  • Fairfield, TX
National Provider Identifier
1871918565
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S6092 Issued in TX
Practice address
734 W Commerce St
Fairfield, TX 75840-1428
Phone
(903) 389-0926
Fax
(903) 389-0907
NPI assigned
Mar 4, 2014
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S6092 TX
Family Medicine Physician 207Q00000X S6092 TX Primary

Addresses

Primary practice location

734 W Commerce St
Fairfield, TX 75840-1428

Mailing address

734 W Commerce St
Fairfield, TX 75840-1428
Phone (903) 389-0926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201016000453 TX Practitioner - Family Practice 8123365566 Reassigns benefits to 2 organizations
I20241008003013 TN Practitioner - Family Practice 8123365566 Reassigns benefits to 1 organization
I20241017000104 TN Practitioner - Emergency Medicine 8123365566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfield Hospital DistrictGroup PAC ID 6507149192, 20 clinicians
Emergency Medical Care Facilities PCGroup PAC ID 6103837877, 57 clinicians

Practice addresses (Care Compare)

125 Newman St
Fairfield, TX 75840-1419
Phone (903) 389-2121

144 Humphreys St
Buffalo, TX 75831-7555
Phone (903) 480-0041

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S6092TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WT University Medical Associates Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Fairfield Hospital District Current Accepting new patients
Fairfield Hospital District Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Oct 20, 2025 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince Aug 9, 2024 Accepting new patients
University of Tennessee Family Medicine Current Accepting new patients
Fairfield Hospital District Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Fairfield Hospital District Past Accepting new patients
Liberty County Hospital District No. 1 Past Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Fl 5
Jackson, TN 38301
Phone (731) 423-1932

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

734 W Commerce St
Fairfield, TX 75840
Phone (903) 389-1681

734 W Commerce St
Ste C
Fairfield, TX 75840
Phone (903) 389-2121

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Interoperability endpoints

  • Direct secure messaging: fmcmwawer@yourcarecommunity.org
  • FHIR API: https://fhir.yourcareuniverse.net/tenant/011a4a74-dd3f-4ea4-ba83-ca6efe6b6b57
  • Direct secure messaging: mark.waweru.1@14618.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1871918565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 W COMMERCE ST",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758401428",
            "telephone_number": "903-389-0926",
            "fax_number": "903-389-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 W COMMERCE ST",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758401428",
            "telephone_number": "903-389-0926",
            "fax_number": "903-389-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWERU",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-04",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S6092",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S6092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, TX

Sources for this page

Verify at the official NPI Registry.