Individual provider Active NPI

Kathryn C Watt, NPC

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1154446862
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN170324 Issued in GA
Practice address
410 Connell Rd
Valdosta, GA 31602-1407
Phone
(229) 244-4720
Fax
(229) 247-1084
NPI assigned
Mar 20, 2007
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN170324 GA Primary

Addresses

Primary practice location

410 Connell Rd
Valdosta, GA 31602-1407

Mailing address

410 Connell Rd
Valdosta, GA 31602-1407
Phone (229) 244-4720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070430000406 GA Practitioner - Nurse Practitioner 0749386258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwell Ambulatory IncGroup PAC ID 9234566779, 11 clinicians

Practice addresses (Care Compare)

2922 N Oak St
Suite C
Valdosta, GA 31602-1885
Phone (229) 262-6810

901 18TH St E
Tifton, GA 31794-3648
Phone (229) 382-7120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.26 of 100Reported as group
Quality
91.03
Promoting interoperability
100
Improvement activities
40
Cost
79.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN170324GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Gastroenterology Associates, LLC CurrentSince Apr 1, 2007 Accepting new patients
Southwell Ambulatory Inc Current Accepting new patients
Southwell Ambulatory Inc CurrentSince Jan 1, 2020 Accepting new patients
Tift Regional Health System, Inc. CurrentSince Jan 1, 2020 Accepting new patients

Locations

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

2922 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 244-1570

3790 Old US Highway 41 N
Ste B
Valdosta, GA 31602
Phone (229) 241-8811

410 Connell Rd
Valdosta, GA 31602
Phone (229) 244-1570

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20731/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kathryn.watt.1@20731.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1154446862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CONNELL RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021407",
            "telephone_number": "229-244-4720",
            "fax_number": "229-247-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CONNELL RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021407",
            "telephone_number": "229-244-4720",
            "fax_number": "229-247-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "KATHRYN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN170324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.