Tracy Woodrow Watson Jr., CRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN176205 Issued in OH

Practice address

17638 Walnut TRL
Chagrin Falls, OH 44023-6414

Phone

(440) 708-2964

Fax

(440) 708-0254

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Clinic Physician Services Co. LLC

  • Anesthesiology Physician
  • Mayfield HTS, OH
  • NPI 1235127408
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194720763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17638 WALNUT TRL",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440236414",
            "telephone_number": "440-708-2964",
            "fax_number": "440-708-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17638 WALNUT TRL",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440236414",
            "telephone_number": "440-708-2964",
            "fax_number": "440-708-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TRACY",
        "middle_name": "WOODROW",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN176205",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA03676",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0176554",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Walton
• Kimberly Ann Wanen, LPN
• Andrea Ward, MD
• Carol Warnick, EDS
• Washington Square Chiropractic Clinic, LLC
• Susan Levy Wayne
• Lori Ann Weber
• Wendy Weinberg Weil, E1600081S. LPCC-S
• Zachery R Weinberg, OD
• Carey Sullivan Wentzel, M.S., CF-SLP

• Registered Nurse in Chagrin Falls, OH
• Providers in Chagrin Falls, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.