Individual provider Active NPI

Elizabeth K Watson, NP

  • Family Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1063501757
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN112289 Issued in GA
Practice address
2916 Glynn Ave
Brunswick, GA 31520-4844
Phone
(912) 466-5850
Fax
(912) 466-5881
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN112289 GA Primary

Addresses

Primary practice location

2916 Glynn Ave
Brunswick, GA 31520-4844

Mailing address

2916 Glynn Ave
Brunswick, GA 31520-4844
Phone (912) 466-5850

Other identifiers 1

IdentifierTypeStateIssuer
105906343IMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20041020000806 GA Practitioner - Nurse Practitioner 0143208264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.36 of 100Reported as group
Quality
46.72
Promoting interoperability
99
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc CurrentSince Jul 8, 2005 Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients
Jesup Emergency Services, LLC Past Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients

Locations

2916 Glynn Ave
Brunswick, GA 31520
Phone (912) 265-3210

3400 Parkwood Dr
Brunswick, GA 31520
Phone (912) 267-7600

3300 4th St
Brunswick, GA 31520
Phone (912) 267-0884

1 King and Prince Blvd
Brunswick, GA 31520
Phone (912) 261-7003

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

1022 Miller Ln SW
Darien, GA 31305
Phone (912) 257-8028

311 Highway 251
Darien, GA 31305
Phone (912) 437-4157

5000 Wellness Way
St Simons Island, GA 31522
Phone (912) 466-5900

Interoperability endpoints

  • Direct secure messaging: ewatson@secure.sghsmessaging.org

Organizations & group practices 4

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1063501757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204844",
            "telephone_number": "912-466-5850",
            "fax_number": "912-267-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204844",
            "telephone_number": "912-466-5850",
            "fax_number": "912-466-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ELIZABETH",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN112289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105906343I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.