Individual provider Active NPI

Julia Waters, FNP-C

  • Family Nurse Practitioner
  • Lyons Falls, NY
National Provider Identifier
1962140368
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349592 Issued in NY
Practice address
3926 State Route 12
Lyons Falls, NY 13368
Phone
(315) 348-8407
Fax
(315) 248-4162
NPI assigned
May 25, 2022
Last updated
Dec 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 349592 NY Primary

Addresses

Primary practice location

3926 State Route 12
Lyons Falls, NY 13368

Mailing address

PO Box 247
Lyons Falls, NY 13368-0247
Phone (315) 348-8407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20220822002080 NY Practitioner - Nurse Practitioner 2264815372 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis CountyGroup PAC ID 2668463779, shared by 14 NPIs, 39 clinicians

Practice addresses (Care Compare)

3926 State Route 12
Lyons Falls, NY 13368-1919
Phone (315) 348-8407

7785 N State St
FL 3
Lowville, NY 13367-1229
Phone (315) 376-5287

9559 Main St
Beaver Falls, NY 13305-0000
Phone (315) 346-6824

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County General Hospital Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lewis County CurrentSince Jul 1, 2022 Accepting new patients
Lewis County General Hospital Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lewis County General Hospital Current Accepting new patients
Lewis County General Hospital Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lewis County Past Accepting new patients

Locations

7785 N State St
Lowville, NY 13367
Phone (315) 376-5102

7785 N State St
Fl 3
Lowville, NY 13367
Phone (315) 376-5287

3926 State Route 12
Lyons Falls, NY 13368
Phone (315) 348-8407

Organizations & group practices 6

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 2

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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1962140368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LYONS FALLS",
            "state": "NY",
            "postal_code": "133680247",
            "telephone_number": "315-348-8407",
            "fax_number": "315-248-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3926 STATE ROUTE 12",
            "city": "LYONS FALLS",
            "state": "NY",
            "postal_code": "13368",
            "telephone_number": "315-348-8407",
            "fax_number": "315-248-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JULIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons Falls, NY

Sources for this page

Verify at the official NPI Registry.