Individual provider Active NPI

Andrea Watson, DC, MS, MBA

  • Chiropractor
  • Las Vegas, NV
National Provider Identifier
1184272601
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B01510 Issued in NV
Practice address
10420 S Decatur Blvd Ste 140
Las Vegas, NV 89141-8717
Phone
(702) 332-3355
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X B01510 NV Primary

Addresses

Primary practice location

10420 S Decatur Blvd Ste 140
Las Vegas, NV 89141-8717

Mailing address

9611 Stoney Mesa CT
Las Vegas, NV 89139-7403
Phone (702) 885-6166

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL ScaledFitness.com
Other URL ScaledFitness.com Direct

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
Credentials
Master of Business Administration, Master of Science

State licenses

LicenseStateTypeSpecialty
B01510NVMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1184272601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 STONEY MESA CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397403",
            "telephone_number": "702-885-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 S DECATUR BLVD STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891418717",
            "telephone_number": "702-332-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "DC, MS, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B01510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ScaledFitness.com",
            "affiliation": "N",
            "address_1": "10420 S Decatur Blvd Ste 140",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891418717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ScaledFitness.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10420 S Decatur Blvd Ste 140",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891418717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.