Individual provider Active NPI

Tanya Watson

  • Nurse Practitioner
  • Westland, MI
National Provider Identifier
1134839707
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704284426 Issued in MI
Practice address
38410 Cherry Hill Rd
Westland, MI 48185-3270
Phone
(706) 271-0100
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704284426 MI Primary

Addresses

Primary practice location

38410 Cherry Hill Rd
Westland, MI 48185-3270

Mailing address

PO Box 2444
Dalton, GA 30722-2444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221208001436 MI Practitioner - Nurse Practitioner 5496124703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Medical Associates PCGroup PAC ID 2860743309, 23 clinicians

Practice addresses (Care Compare)

27560 Hoover Rd
Warren, MI 48093-4505
Phone (586) 573-5890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704284426MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Geriatrics PLLC CurrentSince Dec 5, 2022 Accepting new patients
Pioneer Endoscopy & Surgery Center, L.L.C. CurrentSince Apr 1, 2023 Accepting new patients
Pioneer Medical Associates P.C. Nurse Practitioner CurrentSince Apr 1, 2023 Accepting new patients
Paramount Medical Group PC Current Accepting new patients
St. Clair Medical Associates, P.C. Past Accepting new patients

Locations

200 N Canton Center Rd
Canton, MI 48187
Phone (734) 656-8883

520 Main St
#M
Manistique, MI 49854
Phone (906) 341-6921

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

38410 Cherry Hill Rd
Westland, MI 48185
Phone (734) 326-1200

8365 N Newburgh Rd
#Four
Westland, MI 48185
Phone (734) 416-2000

Interoperability endpoints

  • Direct secure messaging: twatson1157144@direct.hfhs.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIBBA

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1134839707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2444",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307222444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38410 CHERRY HILL RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481853270",
            "telephone_number": "706-271-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704284426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

Verify at the official NPI Registry.