Sallie Jane Waters, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23254 Issued in OK

Practice address

1313 Jackie Rd.
Duncan, OK 73533

Phone

(580) 251-8212

Fax

(580) 252-1020

NPI assigned

Nov 7, 2006

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

Other identifiers 1

Other names 1

• Sallie Jane Sturdevant Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Duncan Regional Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Duncan, OK
  • NPI 1942918214

  Family Medicine

  NPD (past)
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1982773685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 JACKIE RD.",
            "address_2": "WATERS FAMILY MEDICINE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "73533",
            "telephone_number": "580-251-8212",
            "fax_number": "580-252-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 JACKIE RD.",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "73533",
            "telephone_number": "580-251-8212",
            "fax_number": "580-252-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "SALLIE",
        "middle_name": "JANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200014900A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLIE",
            "last_name": "STURDEVANT",
            "middle_name": "JANE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cindy Walker
• Timothy Paul Walker, O.D.
• Alisha Suzanne Ward, MS, LADC-MH
• Christopher Adam Ward
• Preston A Waters, M.D.
• Kimberly M. Weaver, MD
• Ramsey Webb, COTA/L
• Jessica Renee Weddington-Nunez, RD
• Carol Ann Weddle, ARNP
• Robert James Weedn, M.D.

• Family Medicine Physician in Duncan, OK
• Providers in Duncan, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.