Mark Wathen, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

23921 Issued in TN

Practice address

228 W 4TH St
Suite 200
Cookeville, TN 38501-2488

Phone

(931) 372-0405

Fax

(931) 372-0463

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiac Electrophysiology

Education

Louisiana State University School of Medicine in New Orleans, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CRMC Mso Sub 1 IncorporatedGroup PAC ID 1052332830, 21 clinicians

Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score

62.7 of 100Reported as individual

Quality

65.61

Promoting interoperability

0

Improvement activities

40

Cost

82.18

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• CRMC Mso Sub 1, Incorporated

  • Specialist
  • Cookeville, TN
  • NPI 1972648319
  Medicare reassignment Care Compare group NPD
• Stern Cardiovascular Center, PA

  • Cardiovascular Disease Physician
  • Germantown, TN
  • NPI 1699790311
  Medicare reassignment Care Compare group
• Cookeville Regional Medical Center

  • Hospitalist Physician
  • Cookeville, TN
  • NPI 1023397031

  Cardiovascular Disease

  NPD (past)
• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  NPD (past)

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

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1104925536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012488",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012488",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATHEN",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "23921",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "23921",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "23921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4288686",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509597",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Jacob Wallace, PA
• Amy Catherine Ward, BS
• Tiffany Ward, FNP
• Washington Ave Family Practice
• William Walter Wassynger, M.D.
• Jimmie Gregory Watkins, DPM
• Sharonda Watkins
• Shelby Watkins, PA-C
• Tammy Watkins
• Sunday Watson

• Clinical Cardiac Electrophysiology Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Clinical Cardiac Electrophysiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.