NPIMap

Individual provider Active NPI

Kristin J Watson, P.A.

  • Physician Assistant
  • Manistee, MI
National Provider Identifier
1023451887
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006629 Issued in MI
Practice address
2198 US 31 S
Manistee, MI 49660-9618
Phone
(231) 723-3567
Fax
(231) 723-1767
NPI assigned
Apr 11, 2013
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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 5601006629 MI Primary

Addresses

Primary practice location

2198 US 31 S
Manistee, MI 49660-9618

Mailing address

6227 Frankfort Hwy
Benzonia, MI 49616-8632
Phone (231) 882-9661

Other practice location 1

400 Hobart St
Cadillac, MI 49601-2331
Phone (231) 935-6600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristin.watson@wsmcps.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130624000411 MI Practitioner - Physician Assistant 6608015672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1465 E Parkdale Ave
West Shore Medical Center
Manistee, MI 49660-9709
Phone (231) 723-3501

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Manistee Hospital CurrentSince Apr 3, 2017 Accepting new patients
Munson Healthcare Cadillac CurrentSince Dec 3, 2019 Accepting new patients
Munson Healthcare Manistee Hospital Past Accepting new patients

Locations

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

1293 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1735

1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1023451887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6227 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496168632",
            "telephone_number": "231-882-9661",
            "fax_number": "231-882-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2198 US 31 S",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609618",
            "telephone_number": "231-723-3567",
            "fax_number": "231-723-1767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012331",
            "country_code": "US",
            "telephone_number": "231-935-6600",
            "fax_number": "231-935-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KRISTIN",
        "middle_name": "J",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristin.watson@wsmcps.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "400 Hobart St",
            "city": "Cadillac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496012331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

Verify at the official NPI Registry.