Individual provider Active NPI

David R Watt, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Annapolis, MD
National Provider Identifier
1164464103
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
D40106 Issued in MD
Practice address
2002 Medical Pkwy
#450
Annapolis, MD 21401-3046
Phone
(410) 224-6680
Fax
(410) 224-4620
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D40106 MD
Retina Specialist (Ophthalmology) Physician 207WX0107X D40106 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy
#450
Annapolis, MD 21401-3046

Mailing address

2002 Medical Pkwy
#450
Annapolis, MD 21401-3046
Phone (410) 224-6680

Other identifiers 1

IdentifierTypeStateIssuer
150761300MedicaidMD

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1164464103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "#450",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-224-6680",
            "fax_number": "410-224-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "#450",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-224-6680",
            "fax_number": "410-224-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D40106",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MD",
            "license": "D40106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150761300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.