NPIMap

Individual provider Active NPI

Donald O Watson, D.O.

  • Internal Medicine Physician
  • Cheboygan, MI
National Provider Identifier
1053337535
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101013301 Issued in MI
Practice address
740 S Main St
Cheboygan, MI 49721-2220
Phone
(231) 627-1282
Fax
(231) 627-1850
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101013301 MI Primary

Addresses

Primary practice location

740 S Main St
Cheboygan, MI 49721-2220

Mailing address

PO Box 419
Cheboygan, MI 49721-0419
Phone (231) 627-1438

Other identifiers 5

IdentifierTypeStateIssuer
110A610070OtherMIGROUP BLUE CROSS - IM
4443438MedicaidMI
4745644MedicaidMI
1151600184OtherMIINDIVIDUAL BLUE CROSS
010A660000OtherMIGROUP BLUE CROSS - HOSP

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
I20080904000203 MI Practitioner - Internal Medicine 0941379572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

740 S Main St
Cheboygan, MI 49721-2220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101013301MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Northern Michigan CurrentSince Jun 1, 2013 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan Current Accepting new patients
McLaren Northern Michigan CurrentSince Jun 1, 2013 Accepting new patients
Community Memorial Hospital Past Accepting new patients
Community Memorial Hospital Internal Medicine Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

748 S Main St
Cheboygan, MI 49721
Phone (231) 627-5601

740 S Main St
Cheboygan, MI 49721
Phone (231) 627-4361

740 S Main St
Ste A
Cheboygan, MI 49721

740 S Main St
Ste 3A
Cheboygan, MI 49721
Phone (231) 627-1282

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

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 8

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1053337535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497210419",
            "telephone_number": "231-627-1438",
            "fax_number": "231-627-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-1282",
            "fax_number": "231-627-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DONALD",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101013301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BLUE CROSS - IM",
            "identifier": "110A610070",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4443438",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4745644",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BLUE CROSS",
            "identifier": "1151600184",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BLUE CROSS - HOSP",
            "identifier": "010A660000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheboygan, MI

Sources for this page

Verify at the official NPI Registry.