Laci Watson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.015954 Issued in IL

Practice address

2239 E Cook St
Springfield, IL 62703-1944

Phone

(217) 788-2300

Fax

(217) 788-2343

NPI assigned

May 3, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 26, 2020 through Oct 26, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwatsonnp@wholefamily.medentdirect.com

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.

• Whole Family Wellness LLC

  • Nurse Practitioner
  • Taylorville, IL
  • NPI 1710789003
  NPD
• Thomas Rohde, M.D., LTD

  • Health Service Clinic/Center
  • Decatur, IL
  • NPI 1447459540
  NPD (past)
• Toofan Medical Holdings, LTD

  dba Taylorville Urgent Care

  • Clinic/Center
  • Taylorville, IL
  • NPI 1679029961
  NPD (past)

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053847509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 MURRAY HILL AVE",
            "city": "TOVEY",
            "state": "IL",
            "postal_code": "625704477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 E COOK ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031944",
            "telephone_number": "217-788-2300",
            "fax_number": "217-788-2343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 W Springfield Rd",
            "address_purpose": "LOCATION",
            "city": "Taylorville",
            "state": "IL",
            "postal_code": "625682763",
            "country_code": "US",
            "telephone_number": "217-824-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LACI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Watson Orthopaedics LLC
• Jerel Watson, M.D.
• Jillian Watson
• John O Watson, MD
• John Ward Watson, M.D.
• Melissa Kay Watson, CSFA
• Nikki D Watson, CRNA
• Ryan Ridgway Watson, MD
• Watt Bros Pharmacy Inc (Watt Brothers Pharmacy)
• Cody M Watts, BEHAVIOR ANALYST

• Family Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.