Terry Watkin, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

010104747 Issued in VA

Practice address

12007 Sunrise Valley Dr
Suite 120
Reston, VA 20191-3479

Phone

(301) 624-5730

Fax

(301) 624-5731

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pediatric Specialists of Virginia, LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1699119818

  DC

  Medicare reassignment NPD
• Neuroscience Consultants, PLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Reston, VA
  • NPI 1033546908
  NPD (past)
• Neuroscience Consultants, PLC

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Reston, VA
  • NPI 1871508366

  Specialist

  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043315369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79429",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790429",
            "telephone_number": "301-624-5730",
            "fax_number": "301-624-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12007 SUNRISE VALLEY DR",
            "address_2": "SUITE 120",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913479",
            "telephone_number": "301-624-5730",
            "fax_number": "301-624-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKIN",
        "first_name": "TERRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "010104747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CF BC BS DC",
            "identifier": "4571 0003",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007110341",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0500138",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "244468",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "283590",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4053661",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CF BC BS MD/NASCO",
            "identifier": "535088 02",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/ALLIANCE",
            "identifier": "85488",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130018728",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "505096",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lingshu Wang, APRN
• Vanessa Wansel, CRNP
• Warby Parker Inc.
• Alexandra Washington, D.P.T.
• Jeannie Fitzgerald Waters, MA, M.ED
• Watt and Clark L.C.
• Nina Watts
• Rebecca L Weaver, DPT
• Mary Elizabeth Webber
• Karen Wei Erh Isadore Wee, MSW, QMHP-A

• Specialist in Reston, VA
• Providers in Reston, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.