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Deactivated NPI 1104374008 Deactivated / Inactive NPI Male Practitioner

Joshua Waters

Contractor • Valdosta, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Joshua Waters has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 20, 2016
NPI Deactivation Date July 26, 2021
Total Practice Duration ~5 Years of Practice (2016 – 2021)

Professional Overview & Biography Verified Profile Summary

Joshua Waters was a registered Contractor practicing in Valdosta, GA. Throughout an active medical career spanning 5 years, Joshua Waters provided care at the practice location at 3925 N OAK STREET EXT until profile deactivation on 2021-07-26.

Practice Location & Contact Primary Location

Practice Address

3925 N Oak Street Ext
Apt I-916

Valdosta, GA 316057605

Telephone 3197590441

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Valdosta, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.2 Yrs
Regional Practice Density
102 Specialists

Practicing in Valdosta, GA (727 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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NPI Profile Deactivated July 26, 2021

Record deactivated on July 26, 2021

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Updated Practice Location May 06, 2018

Registered at 303 UNIVERSITY DR, VALDOSTA, GA 316022631 (Tel: 2292191811)

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Updated Business Mailing Address May 06, 2018

Registered at 1018 S STARR AVE, BURLINGTON, IA 526013110 (Tel: 3197590441)

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Provider Name / Credentials Updated May 06, 2018

Recorded as JOSHUA WATERS, LMFT

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 06, 2018

Marriage & Family Therapist (License #MFT001611 in GA)

NPI Profile Active September 20, 2016

NPI status registered as active in NPPES database

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Updated Practice Location September 20, 2016

Registered at 3925 N OAK STREET EXT, APT I-916, VALDOSTA, GA 316057605 (Tel: 3197590441)

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Updated Business Mailing Address September 20, 2016

Registered at 3925 N OAK STREET EXT, APT I-916, VALDOSTA, GA 316057605 (Tel: 3197590441)

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Provider Name / Credentials Updated September 20, 2016

Recorded as JOSHUA WATERS

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2016

Contractor

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Initial NPI Registration & Enumeration September 20, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104374008
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2016
Last Update: September 20, 2016
Deactivation Date: July 26, 2021

Mailing Address

3925 N Oak Street Ext, Apt I-916

Valdosta, GA 316057605

Phone: 3197590441

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.