Individual provider Active NPI

Corinne Arrington Watson, MD

  • Pediatrics Physician
  • Port St Lucie, FL
National Provider Identifier
1184069742
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME132785 Issued in FL
Practice address
1095 NW Saint Lucie West Blvd Ste 106
Port St Lucie, FL 34986-1719
Phone
(772) 785-5505
Fax
(772) 785-5599
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2016-01559 NC
Pediatrics Physician 208000000X ME132785 FL Primary
Pediatrics Physician 208000000X 192449 NC

Addresses

Primary practice location

1095 NW Saint Lucie West Blvd Ste 106
Port St Lucie, FL 34986-1719

Mailing address

PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-2832

Other identifiers 2

IdentifierTypeStateIssuer
022400400MedicaidFL
NNAEZOtherFLFLORIDA BLUE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwatson52794@direct.martinhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210125000996 FL Practitioner - Pediatric Medicine 0143634642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Brody School of Medicine at East Carolina University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Memorial Medical Center IncGroup PAC ID 2961300611, 514 clinicians

Practice addresses (Care Compare)

3496 NW Federal Hwy
Jensen Beach, FL 34957-4441
Phone (772) 223-4916

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME132785FLMDPediatrics Physician
192449NCMDPediatrics Physician
2016-01559NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients

Locations

3496 NW Federal Hwy
Ste A
Jensen Beach, FL 34957
Phone (772) 223-5612

3496 NW Federal Hwy
Jensen Beach, FL 34957
Phone (772) 223-4916

1095 NW Saint Lucie West Blvd
Ste 106
Port St Lucie, FL 34986
Phone (772) 785-5505

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: cwatson2501018@direct.ccf.org

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1184069742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-2832",
            "fax_number": "772-223-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 NW SAINT LUCIE WEST BLVD STE 106",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861719",
            "telephone_number": "772-785-5505",
            "fax_number": "772-785-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CORINNE",
        "middle_name": "ARRINGTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2016-01559",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME132785",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "192449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022400400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "NNAEZ",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwatson52794@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "1095 NW Saint Lucie West Blvd Ste 106",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349861719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.