Individual provider Active NPI

Van Buren Watts III

  • Physical Therapist
  • Greenbelt, MD
National Provider Identifier
1154447605
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20689 Issued in MD
Practice address
7501 Greenway Center Dr
Ste 800
Greenbelt, MD 20770-3514
Phone
(301) 220-3009
Fax
(301) 220-2373
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20689 MD Primary

Addresses

Primary practice location

7501 Greenway Center Dr
Ste 800
Greenbelt, MD 20770-3514

Mailing address

11216 Cherry Hill Rd
T1
Beltsville, MD 20705-3821
Phone (301) 595-0646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20689MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Sports & Rehabilitation Physical Therapist Past Accepting new patients
Achieve It Physical Therapy Physical Therapist PastSince Dec 3, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154447605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 CHERRY HILL RD",
            "address_2": "T1",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053821",
            "telephone_number": "301-595-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 GREENWAY CENTER DR",
            "address_2": "STE 800",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703514",
            "telephone_number": "301-220-3009",
            "fax_number": "301-220-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "VAN BUREN",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.