Active NPI
Antoneil Watt
- Licensed Practical Nurse
- Scranton, PA
National Provider Identifier
1093631590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 299951
- Practice address
- 1310 Pittston Ave
Scranton, PA 18505-1553 - Phone
- (404) 953-2458
- NPI assigned
- Jun 29, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 299951 | PA | Primary |
Addresses
Primary practice location
1310 Pittston Ave
Scranton, PA 18505-1553
Mailing address
1310 Pittston Ave
Scranton, PA 18505-1553
Phone (404) 953-2458
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782691200000",
"number": "1093631590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 PITTSTON AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185051553",
"telephone_number": "404-953-2458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 PITTSTON AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185051553",
"telephone_number": "404-953-2458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATT",
"first_name": "ANTONEIL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-29",
"last_updated": "2026-06-29",
"certification_date": "2026-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "PA",
"license": "299951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.