Active NPI
Ivan Watts
- Surgical Technologist
- Ann Arbor, MI
National Provider Identifier
1134562192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- Practice address
- 812 Avis Dr
Ann Arbor, MI 48108-9649 - Phone
- (800) 638-7564
- Fax
- (734) 622-0452
- NPI assigned
- Apr 9, 2013
- Last updated
- Apr 9, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | NU | Primary |
Addresses
Primary practice location
812 Avis Dr
Ann Arbor, MI 48108-9649
Mailing address
9578 Sims Dr
Apt B9
El Paso, TX 79925-7242
Phone (734) 717-5739
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": "1365465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365465600000",
"number": "1134562192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9578 SIMS DR",
"address_2": "APT B9",
"city": "EL PASO",
"state": "TX",
"postal_code": "799257242",
"telephone_number": "734-717-5739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 AVIS DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481089649",
"telephone_number": "800-638-7564",
"fax_number": "734-622-0452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "IVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-09",
"last_updated": "2013-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.