Active NPI
Julie Anne Watson, M.D.
- Anesthesiology Physician
- Louisville, KY
National Provider Identifier
1154315844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25379
- Practice address
- 4000 Kresge Way
Louisville, KY 40207-4605 - Phone
- (502) 259-5391
- Fax
- (502) 259-9733
- NPI assigned
- Sep 8, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25379 | KY | Primary |
Addresses
Primary practice location
4000 Kresge Way
Louisville, KY 40207-4605
Mailing address
PO Box 34748
Louisville, KY 40232-4748
Phone (502) 259-5391
Other practice location 1
3920 Dutchmans Ln
Louisville, KY 40207-4702
Phone (502) 259-6710
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100378480A | Medicaid | IN | |
| 64253792 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25379 | KY | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1154315844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34748",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402324748",
"telephone_number": "502-259-5391",
"fax_number": "502-259-9733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 KRESGE WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074605",
"telephone_number": "502-259-5391",
"fax_number": "502-259-9733"
}
],
"practiceLocations": [
{
"address_1": "3920 Dutchmans Ln",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402074702",
"country_code": "US",
"telephone_number": "502-259-6710",
"fax_number": "502-259-6704",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "JULIE",
"middle_name": "ANNE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-08",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KY",
"license": "25379",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100378480A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64253792",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.