Individual provider Active NPI

Karen Adrienne Watts, FNP

  • Family Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1043295405
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN059345 Issued in AZ
Practice address
3970 W 24TH St Ste 214
Yuma, AZ 85364-9263
Phone
(928) 341-0058
Fax
(928) 341-0138
NPI assigned
Dec 8, 2005
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN059345 AZ Primary

Addresses

Primary practice location

3970 W 24TH St Ste 214
Yuma, AZ 85364-9263

Mailing address

340 W 32ND St
#378
Yuma, AZ 85364-8128
Phone (928) 341-0058

Other identifiers 3

IdentifierTypeStateIssuer
1356548085OtherAZGROUP NPI
115659OtherAZGROUP LEGACY PIN
324319MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051006000401 AZ Practitioner - Nurse Practitioner 2769407030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3970 W 24TH St
Suite 214
Yuma, AZ 85364-9263
Phone (928) 341-0058

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN059345AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients
San Luis Walk-in Clinic, Inc. PastSince May 17, 2020 Accepting new patients
Crossroads Mission First Step Center Past Accepting new patients
Crossroads Mission Past Accepting new patients
Southwest Emergency Physicians, PLLC Past Accepting new patients

Organizations & group practices 6

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 1

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1043295405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W 32ND ST",
            "address_2": "#378",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648128",
            "telephone_number": "928-341-0058",
            "fax_number": "928-341-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 W 24TH ST STE 214",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853649263",
            "telephone_number": "928-341-0058",
            "fax_number": "928-341-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "KAREN",
        "middle_name": "ADRIENNE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN059345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1356548085",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP LEGACY PIN",
            "identifier": "115659",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324319",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.