Individual provider Active NPI

Perry L Watkins, RN BSN MBA

  • Administrator Registered Nurse
  • Merced, CA
National Provider Identifier
1063778470
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
RN452408 Issued in CA
Practice address
300 E 15TH St
Merced, CA 95341-6217
Phone
(209) 381-6800
Fax
(209) 725-3775
NPI assigned
Apr 10, 2012
Last updated
Apr 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X RN452408 CA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN452408 CA

Addresses

Primary practice location

300 E 15TH St
Merced, CA 95341-6217

Mailing address

300 E 15TH St
Merced, CA 95341-6217
Phone (209) 381-6800

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
Bachelor on Science - Nursing, Master of Business Administration, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN452408CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1063778470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E 15TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416217",
            "telephone_number": "209-381-6800",
            "fax_number": "209-725-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 15TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416217",
            "telephone_number": "209-381-6800",
            "fax_number": "209-725-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "PERRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "RN BSN MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "RN452408",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "RN452408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.