NPIMap

Individual provider Active NPI

Casey Nicole Watkins, MD

  • Nephrology Physician
  • Cheyenne, WY
National Provider Identifier
1124317995
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
TL3638 Issued in WY
Practice address
2301 House Ave
Suite 207
Cheyenne, WY 82001-3176
Phone
(307) 432-0335
Fax
(307) 432-0341
NPI assigned
Apr 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD041597 DC
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X TL3638 WY Primary

Addresses

Primary practice location

2301 House Ave
Suite 207
Cheyenne, WY 82001-3176

Mailing address

PO Box 20970
Cheyenne, WY 82003-7020
Phone (307) 432-0335

Other names 1

  • Casey Nicole Berry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200429002436 SD Practitioner - Nephrology 3577788983 Reassigns benefits to 1 organization
I20201030002005 NE Practitioner - Nephrology 3577788983 Reassigns benefits to 1 organization
I20210915002397 TX Practitioner - Internal Medicine 3577788983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Texas Medical Branch at Galveston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians
Rosebud Indian Health ServiceGroup PAC ID 6901704055, 76 clinicians

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

400 Soldier Creek Dr
Rosebud, SD 57570-8502
Phone (918) 457-8945

640 Flormann St
Rapid City, SD 57701-4679
Phone (605) 755-3300

825 Centennial Dr
Chadron, NE 69337-9400
Phone 30843255869400

PO Box
Suite 400
Rosebud, SD 57570

Hospital & facility affiliations

  • DaVita Rosebud Dialysis Dialysis facility, Rosebud, SD, CCN 432504
  • Monument Health Dialysis LLC Rapid City Dialysis facility, Rapid City, SD, CCN 432518
  • Chadron Hospital Dialysis facility, Chadron, NE, CCN 282313
  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Chadron Hospital Hospital, Chadron, NE, CCN 281341
  • PHS Indian Hospital at Rosebud Hospital, Rosebud, SD, CCN 430084
  • Monument Health Sturgis Hospital Hospital, Sturgis, SD, CCN 431321
  • Monument Health Custer Hospital Hospital, Custer, SD, CCN 431323

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.52 of 100Reported as group
Quality
68.64
Promoting interoperability
91
Improvement activities
40
Cost
86.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD041597DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rosebud Indian Health Service CurrentSince Aug 20, 2021 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince May 1, 2020 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Oct 5, 2020 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince May 1, 2020 Accepting new patients
Rosebud Indian Health Service CurrentSince Aug 20, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

825 Centennial Dr
Chadron, NE 69337
Phone (308) 432-4441

300 E 8th St
Gordon, NE 69343
Phone (308) 282-0401

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

640 Flormann St
Rapid City, SD 57701
Phone (605) 341-3140

Organizations & group practices 8

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1124317995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20970",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037020",
            "telephone_number": "307-432-0335",
            "fax_number": "307-432-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOUSE AVE",
            "address_2": "SUITE 207",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013176",
            "telephone_number": "307-432-0335",
            "fax_number": "307-432-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "CASEY",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD041597",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WY",
            "license": "TL3638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "BERRY",
            "middle_name": "NICOLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.