Individual provider Active NPI

Adam Michael Watson, M.D.

  • Psychiatry Physician
  • Grand Rapids, MI
National Provider Identifier
1174083679
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301505280 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 456-0857
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 4301505280 MI Primary

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Other practice location 1

2006 Hogback Rd Ste 1
Ann Arbor, MI 48105-9750
Phone (734) 786-2300

Other practice location 2

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301505280MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital Psychiatry CurrentSince Jul 1, 2021 Accepting new patients
Mercy Health Partners CurrentSince Oct 1, 2023 Accepting new patients
St Joseph Mercy Hospital CurrentSince Jul 1, 2021 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Jul 1, 2021 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Jul 1, 2021 Accepting new patients
Metropolitan Hospital Psychiatry CurrentSince Aug 1, 2024 Accepting new patients
Mercy Health Partners CurrentSince Oct 1, 2023 Accepting new patients

Locations

2006 Hogback Rd
Ste 1
Ann Arbor, MI 48105
Phone (734) 325-4572

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
Stop E3A
Livonia, MI 48152

125 E Southern Ave
#120
Muskegon, MI 49442
Phone (231) 672-4950

4685 Belding Rd NE
Rockford, MI 49341
Phone (616) 252-3100

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

Interoperability endpoints

  • Direct secure messaging: awatson42985@direct.trinity-health.org

Organizations & group practices 8

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1174083679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-456-0857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2006 Hogback Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481059750",
            "country_code": "US",
            "telephone_number": "734-786-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199606",
            "country_code": "US",
            "telephone_number": "616-252-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301505280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.