Individual provider Active NPI

Garry Duane Waterman, LMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1932146230
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801064188 Issued in MI
Practice address
1205 E Wackerly St
Midland, MI 48642-7035
Phone
(989) 832-9161
Fax
(989) 832-8813
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801064188 MI Primary

Addresses

Primary practice location

1205 E Wackerly St
Midland, MI 48642-7035

Mailing address

1205 E Wackerly St
Midland, MI 48642-7035
Phone (989) 832-9161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150220001067 MI Practitioner - Clinical Social Worker 4385969013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Medicine Associates of Mid Michigan PCGroup PAC ID 6103823406, 7 clinicians

Practice addresses (Care Compare)

1205 E Wackerly St
Midland, MI 48642-7035
Phone (989) 832-9161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801064188MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Medicine Associates of Mid Michigan PC CurrentSince Jan 29, 2015 Accepting new patients

Locations

1205 E Wackerly St
Midland, MI 48642
Phone (989) 832-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1932146230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 E WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427035",
            "telephone_number": "989-832-9161",
            "fax_number": "989-832-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427035",
            "telephone_number": "989-832-9161",
            "fax_number": "989-832-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "GARRY",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801064188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.