Active NPI
Stanley Rudolph Watson, M.D.
- Family Medicine Physician
- Four Oaks, NC
National Provider Identifier
1164524005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 38490
- Practice address
- 864 Black Creek Rd
Four Oaks, NC 27524-8314 - Phone
- (919) 963-3148
- Fax
- (919) 963-2900
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 38490 | NC | Primary |
Addresses
Primary practice location
864 Black Creek Rd
Four Oaks, NC 27524-8314
Mailing address
PO Box 96860
Charlotte, NC 28296-6860
Phone (919) 359-1011
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8985994 | Medicaid | NC | |
| 080063193 | Other | NC | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of North Carolina at Chapel Hill School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
864 Black Creek Rd
Four Oaks, NC 27524-8314
Phone (919) 963-3148
Hospital & facility affiliations
- 3HC
- Centerwell Home Health
- Well Care Home Health of the Southern Triangle, Inc.
- Community Home Care of Vance County
- Johnston Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 18 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38490 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Durham Medical Group, PA | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- stanleywatson@hfmpa.allscriptsdirect.net
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.
-
- Family Medicine Physician
- Hillsborough, NC
- NPI 1194828145
-
- Family Medicine Physician
- Clayton, NC
- NPI 1013371061
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Henderson, NC
- NPI 1841247335
-
- Community Based Hospice Care Agency
- Goldsboro, NC
- NPI 1558396622
Home health agency
-
- Home Health Agency
- Goldsboro, NC
- NPI 1750337366
-
- General Acute Care Hospital
- Smithfield, NC
- NPI 1619911104
-
- Home Health Agency
- Goldsboro, NC
- NPI 1558391391
-
- Home Health Agency
- Holly Springs, NC
- NPI 1508418005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1164524005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 96860",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282966860",
"telephone_number": "919-359-1011",
"fax_number": "919-359-9122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "864 BLACK CREEK RD",
"city": "FOUR OAKS",
"state": "NC",
"postal_code": "275248314",
"telephone_number": "919-963-3148",
"fax_number": "919-963-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "STANLEY",
"middle_name": "RUDOLPH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "38490",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8985994",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080063193",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Four Oaks, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.
- 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.