Active NPI
Susan Gail Watts, MS. RD. LD. CDE.
- Registered Dietitian
- Kerrville, TX
National Provider Identifier
1174534465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT03177
- Practice address
- 3600 Memorial Blvd
Kerrville, TX 78028-5768 - Phone
- (830) 792-2530
- Fax
- (830) 792-2582
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT03177 | TX | Primary |
Addresses
Primary practice location
3600 Memorial Blvd
Kerrville, TX 78028-5768
Mailing address
6700 Braden Cir
Kerrville, TX 78028-8000
Phone (830) 792-8849
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT03177 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Regional Edema Lymphedema and Wound Care Center LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Kerrville, TX
- NPI 1639262264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174534465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 BRADEN CIR",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780288000",
"telephone_number": "830-792-8849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 MEMORIAL BLVD",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780285768",
"telephone_number": "830-792-2530",
"fax_number": "830-792-2582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "SUSAN",
"middle_name": "GAIL",
"name_prefix": "Ms.",
"credential": "MS. RD. LD. CDE.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT03177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kerrville, TX
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.