Individual provider Active NPI

Monique M Watson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1063091205
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
30880 Issued in TN
Practice address
4041 Knight Arnold Rd
Memphis, TN 38118-2128
Phone
(901) 505-0690
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53-82464-012 KS
Registered Nurse 163W00000X 135847 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11026933 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209027389 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 30880 TN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61422162 WA

Addresses

Primary practice location

4041 Knight Arnold Rd
Memphis, TN 38118-2128

Mailing address

1160 Vickery LN Ste 103
Cordova, TN 38016-1647
Phone (901) 877-8996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20221129000746 TN Practitioner - Nurse Practitioner 3375911134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians
Tri State Community Health CenterGroup PAC ID 4486955341, 10 clinicians

Practice addresses (Care Compare)

Knoxville, TN 37923
Phone (415) 360-3348

4041 Knight Arnold Rd
Memphis, TN 38118-2128

4041 Knight Rd
Memphis, TN 38118-2128
Phone (901) 360-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135847TNMDRegistered Nurse
209027389ILMDPsychiatric/Mental Health Nurse Practitioner
53-82464-012KSMDPsychiatric/Mental Health Nurse Practitioner
AP61422162WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince May 1, 2025 Accepting new patients
Cocaine and Alcohol Awareness Program, Inc. PastSince Jun 8, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

8913 Town and Country Cir
Knoxville, TN 37923
Phone (253) 861-0739

Interoperability endpoints

  • Direct secure messaging: monique.watson.p1@direct.tristatechc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1063091205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VICKERY LN STE 103",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380161647",
            "telephone_number": "901-877-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 KNIGHT ARNOLD RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381182128",
            "telephone_number": "901-505-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MONIQUE",
        "middle_name": "M",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-82464-012",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "135847",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11026933",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209027389",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30880",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61422162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.