Individual provider Active NPI

Travis Edward Watts, PHARM.D., CDE, BCPS

  • Pharmacotherapy Pharmacist
  • Oklahoma City, OK
National Provider Identifier
1063415743
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
11493 Issued in OK
Practice address
3625 NW 56TH St
5 Corporate Plaza
Oklahoma City, OK 73112-4519
Phone
(405) 951-3829
Fax
(405) 951-3916
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 11493 OK Primary

Addresses

Primary practice location

3625 NW 56TH St
5 Corporate Plaza
Oklahoma City, OK 73112-4519

Mailing address

1200 Outabounds Dr
Edmond, OK 73034-3079
Phone (405) 285-8766

Other identifiers 3

IdentifierTypeStateIssuer
20510562OtherCDE
3024935OtherBCPS CREDENTIAL
11493OtherOKPHARMACY LISCENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
11493OKMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063415743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OUTABOUNDS DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343079",
            "telephone_number": "405-285-8766",
            "fax_number": "405-951-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 NW 56TH ST",
            "address_2": "5 CORPORATE PLAZA",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124519",
            "telephone_number": "405-951-3829",
            "fax_number": "405-951-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "TRAVIS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., CDE, BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "OK",
            "license": "11493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDE",
            "identifier": "20510562",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCPS CREDENTIAL",
            "identifier": "3024935",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LISCENSE",
            "identifier": "11493",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.