NPIMap

Individual provider Active NPI

Carson Watson Shadix, PA-C

  • Physician Assistant
  • Tuscaloosa, AL
National Provider Identifier
1003415977
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1691 Issued in AL
Practice address
5005 Oscar Baxter Dr
Tuscaloosa, AL 35405-3698
Phone
(205) 343-2225
Fax
(205) 343-7825
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1691 AL Primary

Addresses

Primary practice location

5005 Oscar Baxter Dr
Tuscaloosa, AL 35405-3698

Mailing address

5005 Oscar Baxter Dr
Tuscaloosa, AL 35405-3698
Phone (205) 343-2225

Other names 1

  • Carson Leigh Watson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210225000886 AL Practitioner - Physician Assistant 9931514908 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Northwest PCGroup PAC ID 2062595598, 37 clinicians
Tuscaloosa Medcenter North, LLCGroup PAC ID 9537167721, 24 clinicians
Medcenter Primary Care LLCGroup PAC ID 3274807615, 7 clinicians
Tuscaloosa Medcenter South LLCGroup PAC ID 6305813221, 23 clinicians

Practice addresses (Care Compare)

2708 Hwy 78 E
Jasper, AL 35501-3430
Phone (205) 387-2253

3909 McFarland Blvd
Northport, AL 35476-2838
Phone (205) 333-1993

3909 McFarland Blvd E
Northport, AL 35476-2838
Phone (205) 333-1993

4960 Rice Mine Rd NE
Suite 10
Tuscaloosa, AL 35406-2671
Phone (205) 333-9467

5005 Oscar Baxter Dr
Tuscaloosa, AL 35405-3698
Phone (205) 343-2225

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1691ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Shore Urgent Care LLC PastSince Oct 1, 2020 Accepting new patients
Urgent Care Northwest PC PastSince Aug 1, 2025 Accepting new patients
Urgent Care Northwest PC PastSince Aug 1, 2025 Accepting new patients
Urgent Care Northwest PC PastSince Aug 1, 2025 Accepting new patients
Medcenter Fayette, LLC Past Accepting new patients

Organizations & group practices 11

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1003415977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 OSCAR BAXTER DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354053698",
            "telephone_number": "205-343-2225",
            "fax_number": "205-343-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 OSCAR BAXTER DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354053698",
            "telephone_number": "205-343-2225",
            "fax_number": "205-343-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADIX",
        "first_name": "CARSON",
        "middle_name": "WATSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "1691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARSON",
            "last_name": "WATSON",
            "middle_name": "LEIGH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.