Marilyn Leann Waters, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11003655 Issued in FL

Practice address

4647 Manatee Ave W
Bradenton, FL 34209-3816

Phone

(941) 745-5999

Fax

(941) 745-3555

NPI assigned

Aug 13, 2019

Sex

Female

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marilyn.waters.1@11352.direct.athenahealth.com

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.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  Family

  Medicare reassignment NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• MCR Health, Inc.

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1730115882
  NPD (past)
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Palmetto, FL
  • NPI 1841236247
  NPD (past)

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1881240273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATTN: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "941-745-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093816",
            "telephone_number": "941-745-5999",
            "fax_number": "941-745-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9908 SR 64 East",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342125303",
            "country_code": "US",
            "telephone_number": "941-747-8600",
            "fax_number": "941-749-5915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6272 Lake Osprey Dr",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342408425",
            "country_code": "US",
            "telephone_number": "941-907-2800",
            "fax_number": "941-907-9434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MARILYN",
        "middle_name": "LEANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomasz Wasik
• Edward John Wasloski, O.D.
• Jeffrey R Wasserman, DO
• Angel Wasson, FNP-BC
• Waters Edge of Bradeton
• Melanie Elizabeth Waters
• Waterside Dermatology PLLC
• Veronica Watkins
• Steven C Watsky, MD
• Jaymee Simpson Watson

• Family Nurse Practitioner in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.