Jared Waters

Physician Assistant · Roanoke, VA

Individual Active NPI

NPI number 1023701927

Practice location

5673 Airport Rd
Roanoke, VA 24012-1119
Phone
(540) 523-8080

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NPI record

NPI
1023701927
Entity type
Individual (Type 1)
Enumeration date
May 29, 2023
Last updated
August 17, 2023
Certified
August 17, 2023
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 0110009479 VA

Mailing address

3111 Grayland Ave
Richmond, VA 23221-3527

Other practice locations (1)

  • 5500 Staples Mill Rd, Henrico, VA 23228-5423 · (540) 523-8080

About Jared Waters

Jared Waters is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 5673 Airport Rd, Roanoke, VA 24012-1119. The NPI number 1023701927 was assigned on May 29, 2023 and the record was last updated on August 17, 2023.

Jared Waters lists a license in the registry: #0110009479 (VA) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jared Waters?

The NPI number is 1023701927.

What is the phone number of Jared Waters?

The phone number listed for the practice location is (540) 523-8080.

Where is Jared Waters located?

5673 Airport Rd, Roanoke, VA 24012-1119.

What is the taxonomy code for Jared Waters?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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