Individual provider Active NPI

Mandel Stephen Watty, MPT

  • Physical Therapist
  • Cherokee, NC
National Provider Identifier
1063883205
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P10298 Issued in NC
Practice address
1 Hospital Road
Caller Box C-268
Cherokee, NC 28719-9253
Phone
(828) 497-9163
Fax
(828) 497-1723
NPI assigned
Oct 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P10298 NC Primary

Addresses

Primary practice location

1 Hospital Road
Caller Box C-268
Cherokee, NC 28719-9253

Mailing address

1 Hospital Road
Caller Box C-268
Cherokee, NC 28719
Phone (828) 497-9163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160425002116 TX Practitioner - Physical Therapist in Private Practice 3375842446 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Indian Hospital Authority CurrentSince Mar 21, 2016 Accepting new patients
Cherokee Indian Hospital Authority Current Accepting new patients
Cherokee Indian Hospital Authority CurrentSince Mar 21, 2016 Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1063883205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL ROAD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "28719",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL ROAD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "287199253",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTY",
        "first_name": "MANDEL",
        "middle_name": "STEPHEN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P10298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.