Individual provider Active NPI

Kimberly Ann Watson, NP-C

  • Nurse Practitioner
  • Tahlequah, OK
National Provider Identifier
1033844865
Registry record updated Jul 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
206172 Issued in OK
Practice address
19600 E Ross St
Tahlequah, OK 74464-0545
Phone
(539) 234-1000
NPI assigned
Jul 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 206172 OK Primary

Addresses

Primary practice location

19600 E Ross St
Tahlequah, OK 74464-0545

Mailing address

2016 E Duke Ave
Stillwater, OK 74075-8290
Phone (918) 448-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130000497 TX Practitioner - Nurse Practitioner 9537530555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawton Indian HospitalGroup PAC ID 6406800234, 126 clinicians

Practice addresses (Care Compare)

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5000

Hospital & facility affiliations

  • Lawton Indian Hospital Hospital, Lawton, OK, CCN 370170

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
206172OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Oct 19, 2022 Accepting new patients
Lawton Indian Hospital CurrentSince Feb 24, 2025 Accepting new patients
Cherokee Nation CurrentSince Oct 19, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

471688 Highway 51
Stilwell, OK 74960

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 7

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 6

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": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1033844865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 E DUKE AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740758290",
            "telephone_number": "918-448-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E ROSS ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640545",
            "telephone_number": "539-234-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "206172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.