Mary Carolyn Watson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

86385 Issued in GA

Practice address

608 Dogwood Dr NE
Pelham, GA 31779-1132

Phone

(850) 815-0063

NPI assigned

Jun 24, 2009

Last updated

Dec 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southland Consolidated Emergency Services, LLC

  • Emergency Medicine Physician
  • Elberton, GA
  • NPI 1174917124
  Medicare reassignment NPD
• Southland Emergency Medical Services, L.L.C

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1477701472
  Medicare reassignment NPD
• Mary Carolyn Watson

  dba Mary Watson MD

  • Family Medicine Physician
  • Pelham, GA
  • NPI 1093475824
  NPD Authorized official

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1053549444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 SHADOWMOSS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085678",
            "telephone_number": "850-815-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 DOGWOOD DR NE",
            "city": "PELHAM",
            "state": "GA",
            "postal_code": "317791132",
            "telephone_number": "850-815-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MARY",
        "middle_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME126349",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "86385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Taylor Speigner, NP
• Strickland Drug Company LLC (Pelham Pharmacy)
• Hunter Mizell Strickland, PHARMD
• Thomas & Son Family & Child Resource Center, Inc
• Walgreen Co (Walgreens #19780)

• Family Medicine Physician in Pelham, GA
• Providers in Pelham, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.