Individual provider Active NPI

Denna R. Watson, PA

  • Medical Physician Assistant
  • New Albany, IN
National Provider Identifier
1083655690
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000218A Issued in IN
Practice address
1919 State St Ste 364
New Albany, IN 47150-6801
Phone
(812) 949-5767
Fax
(812) 948-4339
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA639 KY
Medical Physician Assistant 363AM0700X 10000218A IN Primary

Addresses

Primary practice location

1919 State St Ste 364
New Albany, IN 47150-6801

Mailing address

2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (502) 253-4917

Other identifiers 3

IdentifierTypeStateIssuer
300005223MedicaidIN
IN1189190OtherININ MEDICARE
95001467MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwatson69682@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040610001224 KY Practitioner - Physician Assistant 9830172857 Reassigns benefits to 1 organization
I20170726000378 IN Practitioner - Physician Assistant 9830172857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1373 E State Rd
Madison, IN 47250-7328
Phone (812) 801-0810

1919 State St
New Albany, IN 47150-6804

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000218AINMDMedical Physician Assistant
PA639KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Aug 1, 2017 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 1, 2017 Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1919 State St
Ste 364
New Albany, IN 47150
Phone (812) 949-8355

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1083655690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4917",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STATE ST STE 364",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506801",
            "telephone_number": "812-949-5767",
            "fax_number": "812-948-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DENNA",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA639",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000218A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005223",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MEDICARE",
            "identifier": "IN1189190",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001467",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwatson69682@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1919 State St Ste 364",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471506801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.