Jeremy Shane Watkins, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

1401172821 Issued in VA

Practice address

440 Newcomb St # a
Christiansburg, VA 24073-1326

Phone

(540) 732-7248

NPI assigned

Jan 19, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1073228466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 NEWCOMB ST # A",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731326",
            "telephone_number": "540-732-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 NEWCOMB ST # A",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731326",
            "telephone_number": "540-732-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JEREMY",
        "middle_name": "SHANE",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "VA",
            "license": "1401172821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Christiansburg, VA
• Providers in Christiansburg, VA by specialty
• Nurse's Aide in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.