Watson Clinic ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WATSON CLINIC ASC, LLC

Doing business as

Watson Clinic Surgery Center

Practice address

1315 N Florida Ave
Lakeland, FL 33805-4502

Phone

(863) 680-7000

Fax

(866) 264-8519

NPI assigned

Dec 13, 2023

Last updated

Dec 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason Hirsbrunner

Title

Cao

Phone

(863) 680-7007

Specialties & licenses 1

Addresses

Other names 1

• WATSON CLINIC SURGERY CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Watson Clinic ASC LLC Dba Watson Clinic Surgery CenterCCN 10C0001272

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Watson Clinic ASC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Watson Clinic ASC, LLC

  dba Watson Clinic Surgery Center South

  • Ambulatory Surgical Clinic/Center
  • Lakeland, FL
  • NPI 1972460517
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Watson Clinic LLP

  dba Watson Clinic LLP Plant City

  • Family Medicine Physician
  • Plant City, FL
  • NPI 1437297892

  Member Of

  NPD member

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1154199859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 N FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054502",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATSON CLINIC ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "HIRSBRUNNER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "863-680-7007"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATSON CLINIC SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jean Bednarski Waters, RN
• Heather Lynette Watford
• Jimia Watkins
• Rebecca Watkins
• Haley Watsky, DO
• Watson Clinic ASC, LLC (Watson Clinic Surgery Center South)
• Watson Clinic LLP
• Watson Clinic LLP (Watson Clinic LLP South)
• Watson Clinic LLP
• Watson Clinic LLP (Clinic Prescription Shop)

• Ambulatory Surgical Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.