Active NPI
Brian Wesley Watson, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Myrtle Beach, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 41084
- Practice address
- 809 82ND Pkwy
Myrtle Beach, SC 29572-4607 - Phone
- (843) 692-1495
- Fax
- (843) 449-6213
- NPI assigned
- Mar 12, 2007
- Last updated
- Nov 2, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 079408 | GA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 0101241191 | VA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 41084 | SC | Primary |
Addresses
Primary practice location
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Mailing address
PO Box 741087
Atlanta, GA 30374-1087
Phone (843) 847-4179
Other practice location 1
3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 651-6544
Other practice location 2
9330 Medical Plaza Dr
Charleston, SC 29406
Phone (843) 847-4179
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144352428 | Medicaid | VA | |
| 3810011003 | Medicaid | WV | |
| P00417627 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Virginia Commonwealth University, School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 651-6544
9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 847-4179
Hospital & facility affiliations
- Savannah Health Services LLC Dba Memorial Health University Medical Center
- Doctors Hospital
- Memorial Satilla Health
- Trident Medical Center
- Grand Strand Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101241191 | VA | MD | Anatomic Pathology & Clinical Pathology Physician |
| 0101231191 | VA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dunes Pathology, LLC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Integrated Regional Laboratories Pathology Services, LLC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232
1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030
809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182
9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba IRL Pathology Services
- Anatomic Pathology & Clinical Pathology Physician
- Atlantis, FL
- NPI 1942526298
GA, SC
-
dba Diagnostic Pathology, LLC
- Anatomic Pathology & Clinical Pathology Physician
- Myrtle Beach, SC
- NPI 1821060997
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Grand Strand Medical Center
- General Acute Care Hospital
- Myrlte Beach, SC
- NPI 1083668669
-
dba HCA Healthcare Trident Hospital
- General Acute Care Hospital
- Charleston, SC
- NPI 1366496937
-
dba Doctors Hospital (Augusta)
- General Acute Care Hospital
- Augusta, GA
- NPI 1912951963
-
dba Memorial Health University Medical Center
- General Acute Care Hospital
- Savannah, GA
- NPI 1053824292
-
dba Memorial Satilla Health
- Rural Acute Care Hospital
- Waycross, GA
- NPI 1922530468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572652800000",
"number": "1144352428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 741087",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303741087",
"telephone_number": "843-847-4179",
"fax_number": "843-847-4296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 82ND PKWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724607",
"telephone_number": "843-692-1495",
"fax_number": "843-449-6213"
}
],
"practiceLocations": [
{
"address_1": "3651 Wheeler Rd",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309096521",
"country_code": "US",
"telephone_number": "706-651-6544",
"fax_number": "706-651-6158",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9330 Medical Plaza Dr",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "29406",
"country_code": "US",
"telephone_number": "843-847-4179",
"fax_number": "843-847-4296",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "BRIAN",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2019-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "GA",
"license": "079408",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "VA",
"license": "0101241191",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "SC",
"license": "41084",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144352428",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810011003",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00417627",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2019; 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.