Individual provider Active NPI

Mitchell Todd Watson, D.C.

  • Chiropractor
  • Abingdon, VA
National Provider Identifier
1063743797
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556752 Issued in VA
Practice address
453 W Main St
Abingdon, VA 24210-2630
Phone
(276) 206-8202
Fax
(276) 206-8220
NPI assigned
Jan 20, 2010
Last updated
May 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556752 VA Primary

Addresses

Primary practice location

453 W Main St
Abingdon, VA 24210-2630

Mailing address

453 W Main St
Abingdon, VA 24210-2630
Phone (276) 206-8202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000835 VA Practitioner - Chiropractic 6709914377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

453 W Main St
Abingdon, VA 24210-2630
Phone (276) 206-8202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556752VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Sports and Chiropractic LLC Chiropractor CurrentSince Mar 16, 2010 Accepting new patients

Locations

453 W Main St
Abingdon, VA 24210
Phone (276) 206-8202

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1063743797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 W MAIN ST",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102630",
            "telephone_number": "276-206-8202",
            "fax_number": "276-206-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 W MAIN ST",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102630",
            "telephone_number": "276-206-8202",
            "fax_number": "276-206-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MITCHELL",
        "middle_name": "TODD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.