MR. ADAM LEE WAUGH (NPI# 1487176293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487176293 |
| Entity Type | Individual |
| Full Name | MR. ADAM LEE WAUGH |
| Credential | MPO, CO |
| Practice Address |
17530 Dugdale Dr South Bend IN 46635-1583 |
| Practice Telephone | 5742333352 |
| Mailing Telephone | 5742333352 |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2017-07-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | 213.000354 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
17530 DUGDALE DR |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790209864 | Kelly Ann Roth | Orthotist | 17530 Dugdale Dr, South Bend, IN 46635-1583 | 2017-08-01 |
| 1952825994 | Mark Douglas Singer I | Pedorthist | 17530 Dugdale Dr, South Bend, IN 46635-1583 | 2017-08-01 |
| 1598289654 | Eric Schopmeyer | Orthotist | 17530 Dugdale Dr, South Bend, IN 46635-1583 | 2017-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437301074 | Antonio Mario Sergio Sr. | Orthotist | 1508 Mishawaka Avenue, South Bend, IN 46615-1426 | 2008-10-15 |
| 1790209864 | Kelly Ann Roth | Orthotist | 17530 Dugdale Dr, South Bend, IN 46635-1583 | 2017-08-01 |
| 1598289654 | Eric Schopmeyer | Orthotist | 17530 Dugdale Dr, South Bend, IN 46635-1583 | 2017-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720587520 | Cyrus Maude | Orthotist | 1700 E 38th St # 346, Marion, IN 46953-4568 | 2018-02-07 |
| 1285132324 | Seth Cochrill | Orthotist | 3445 W. 96th St., Indianapolis, IN 46268 | 2018-01-23 |
| 1063653053 | Gary N Barnes | Orthotist | 61 Worman St, Indianapolis, IN 46227-5122 | 2009-03-20 |
| 1871513614 | Larry Lee Libbee | Orthotist | 7735 W Jefferson Blvd, Suite C, Fort Wayne, IN 46804-4135 | 2006-07-21 |
| 1841296340 | Riverside Prosthetic, Inc. | Orthotist | 5921 Vogel Rd, Evansville, IN 47715-4020 | 2005-06-21 |
| 1467949545 | Craig Richard Decamp | Orthotist | 2041 Klondike Rd, West Lafayette, IN 47906-5122 | 2018-04-16 |
| 1174020317 | Douglas Bryant Hodge | Orthotist | 9591 Valparaiso Ct, Indianapolis, IN 46268-1130 | 2018-04-12 |
| 1326549296 | Kathryn Spottiswood | Orthotist | 6629 W Lincoln Hwy Ste 1, Crown Point, IN 46307-5170 | 2018-02-26 |
| 1518483338 | Lauren Danielle Brady | Orthotist | 3445 W 96th St, Indianapolis, IN 46268-1102 | 2017-08-15 |
| 1356865364 | Megan Smith | Orthotist | 3445 W 96th St, Indianapolis, IN 46268-1102 | 2017-08-01 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.