Active NPI
Jennette Watts
- Family Nurse Practitioner
- St George, UT
National Provider Identifier
1124571187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1891478900
- Practice address
- 348 N Bluff St # 202
St George, UT 84770-4832 - Phone
- (435) 772-5370
- NPI assigned
- Jul 26, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1891478900 | UT | Primary |
Addresses
Primary practice location
348 N Bluff St # 202
St George, UT 84770-4832
Mailing address
3770 Carribbean Circle
St George, UT 84790
Phone (435) 772-5370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891478900 | Medicaid | UT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1891478900 | UT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1124571187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3770 CARRIBBEAN CIRCLE",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "84790",
"telephone_number": "435-772-5370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "348 N BLUFF ST # 202",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847704832",
"telephone_number": "435-772-5370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "JENNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "1891478900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891478900",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.