Amber W Waddell, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F06190494 Issued in NC

Practice address

103 Sandreed Dr
Mooresville, NC 28117-4360

Phone

(704) 614-3401

NPI assigned

Nov 4, 2019

Last updated

Nov 4, 2019By the provider in NPPES

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 NC

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

State licenses

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment
• James a. Smith MD Pediatrics

  • Pediatrics Physician
  • Statesville, NC
  • NPI 1912673658
  Authorized official Same address or phone

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1932743846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SANDREED DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174360",
            "telephone_number": "704-614-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SANDREED DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174360",
            "telephone_number": "704-614-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "AMBER",
        "middle_name": "W",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F06190494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Grace Volk, PA-C
• Erica Lee Vollano, FNP-BC
• Frederick U Vorwald, MD
• Vyve Wellness Lake Norman
• W Jason Metzger
• Brandon Wade
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4431)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1156)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Bartosz Adam Walczyszyn, M.D.

• Family Nurse Practitioner in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.