Individual provider Active NPI

Kimberly Kay Watson, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
National Provider Identifier
1225061179
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
18040 Issued in SC
Practice address
7 Independence PT Ste 300
Greenville, SC 29615-4569
Phone
(864) 522-3700
Fax
(864) 522-3705
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041-191136 IL
Certified Registered Nurse Anesthetist 367500000X 209-006258 IL
Certified Registered Nurse Anesthetist 367500000X 18040 SC Primary

Addresses

Primary practice location

7 Independence PT Ste 300
Greenville, SC 29615-4569

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697

Other practice location 1

2202 Harlem Rd
Loves Park, IL 61111-2754
Phone (815) 877-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130301000381 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052318052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

175 Patewood Dr
Greenville, SC 29615-3570
Phone (864) 797-1403

67 Creekside Park CT
Greenville, SC 29615-4810
Phone (864) 522-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.64 of 100Reported as group
Quality
97.3
Promoting interoperability
100
Improvement activities
40
Cost
74.83

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041-191136ILMDRegistered Nurse
209-006258ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 24, 2024 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 24, 2024 Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

Interoperability endpoints

  • Direct secure messaging: kwatson1156760@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1225061179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 Harlem Rd",
            "address_purpose": "LOCATION",
            "city": "Loves Park",
            "state": "IL",
            "postal_code": "611112754",
            "country_code": "US",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-191136",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-006258",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "18040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.