Active NPI
Brooke Elizabeth Watson, PA-C
- Physician Assistant
- Summerville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 5500 Front St Ste 260
Summerville, SC 29486-8140 - Phone
- (843) 576-0700
- Fax
- (843) 576-0701
- NPI assigned
- Sep 25, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
5500 Front St Ste 260
Summerville, SC 29486-8140
Mailing address
PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3386PA | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5500 Front St
Suite 260
Summerville, SC 29486-7735
Phone (843) 376-0670
7 S Alliance Dr
Suite 202a
Goose Creek, SC 29445-7269
Phone (843) 376-0670
Hospital & facility affiliations
- Trident Medical Center
- Roper St Francis Hospital-Berkeley Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PPCP Specialty Physicians , LLC | Current | Accepting new patients | |
| PPCP Specialty Physicians, LLC | Current | Accepting new patients | |
| PPCP Specialty Physicians , LLC | Past | Accepting new patients | |
| PPCP Specialty Physicians, LLC | Past | Accepting new patients |
Locations
7 S Alliance Dr
Ste 202A
Goose Creek, SC 29445
Phone (843) 376-6070
5500 Front St
Ste 260
Summerville, SC 29486
Interoperability endpoints
- brooke.watson@ppcp1.eclinicaldirectplus.com
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.
-
- Gastroenterology Physician
- Goose Creek, SC
- NPI 1780123984
-
- Gastroenterology Physician
- Charleston, SC
- NPI 1093585044
-
- Gastroenterology Physician
- Moncks Corner, SC
- NPI 1861931982
-
- Gastroenterology Physician
- Summerville, SC
- NPI 1861007163
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Summerville, SC
- NPI 1336603646
-
- General Acute Care Hospital
- Charleston, SC
- NPI 1366496937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1114402153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 530062",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303530062",
"telephone_number": "843-695-6071",
"fax_number": "843-569-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 FRONT ST STE 260",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294868140",
"telephone_number": "843-576-0700",
"fax_number": "843-576-0701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "BROOKE",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3386PA",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.