Rolanda Watson, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

041249746 Issued in IL

Practice address

1900 W Polk St
Chicago, IL 60612-3723

Phone

(312) 864-7569

Fax

(312) 864-9009

NPI assigned

Oct 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rolanda Watson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1215403373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604380334",
            "telephone_number": "708-418-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-7569",
            "fax_number": "312-864-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ROLANDA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "IL",
            "license": "041249746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417195876",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821305434",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROLANDA",
            "last_name": "WATSON",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lavon Janeen Watson
• Margo S Watson
• Maria Isabel Watson
• Nichole Watson, FNP-C
• Precious Watson, RN
• Ruby Watson
• Ruevina Watson
• Samantha Watson
• Samantha Lynn Watson
• Stephen Alexander Watson, M.D.

• Case Management Registered Nurse in Chicago, IL
• Providers in Chicago, IL by specialty
• Case Management Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.