Donald B. Waters, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13804 Issued in GA

Practice address

120 E Carter Ave
Blackshear, GA 31516-1561

Phone

(912) 449-4426

Fax

(912) 449-1517

NPI assigned

Jul 6, 2006

Last updated

Oct 21, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

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.

• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  Medicare reassignment NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857

  Family Medicine

  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  GA

  Medicare reassignment NPD
• Mayo Clinic Health System in Waycross, Inc.

  • Psychiatric Hospital Unit
  • Waycross, GA
  • NPI 1285796839
  NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273

  Family Medicine

  NPD
• Integrated Regional Laboratories Pathology Services, LLC

  dba IRL Pathology Services

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlantis, FL
  • NPI 1942526298
  NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Hospice Satilla of Memorial Hospital Inc

  dba Satilla Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Waycross, GA
  • NPI 1508434408
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1972535615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E CARTER AVE",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161561",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E CARTER AVE",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161561",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "DONALD",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "13804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00071904A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Thornton, FNP
• Unison Behavioral Health (Kerrigan Way)
• Unison Behavioral Health
• Walgreen Co (Walgreens #17795)
• Ware County Board of Health
• Gordon Brent Waters, M.D.
• Patricia Marie Weiss
• Tyrone R Williams
• Tiffany Amber Woods, PHARMD
• Sage Laurel Young

• Family Medicine Physician in Blackshear, GA
• Providers in Blackshear, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.