Active NPI
Kimberly Ann Watson, NP-C
- Nurse Practitioner
- Tahlequah, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 206172
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Practice addresses (Care Compare)
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5000
Hospital & facility affiliations
- Lawton Indian Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.4 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 206172 | OK | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Lawton Indian Hospital | Current | Accepting new patients | |
| Cherokee Nation | Current | 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.
-
- Public Health or Welfare Agency
- Tahlequah, OK
- NPI 1013884154
-
- Multi-Specialty Clinic/Center
- Salina, OK
- NPI 1326054081
-
- Multi-Specialty Clinic/Center
- Vinita, OK
- NPI 1558377226
-
- Multi-Specialty Clinic/Center
- Muskogee, OK
- NPI 1841207156
-
- Multi-Specialty Clinic/Center
- Stilwell, OK
- NPI 1992711345
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Federal Public Health Clinic/Center
- Anadarko, OK
- NPI 1881637403
Hospital
-
- Federal Public Health Clinic/Center
- Carnegie, OK
- NPI 1457459158
Hospital
-
- Federal Public Health Clinic/Center
- Clinton, OK
- NPI 1205923448
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.