Individual provider Active NPI

Julieanne Renee Watters, DO

  • Emergency Medicine Physician
  • Washington, PA
National Provider Identifier
1225194178
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS013781 Issued in PA
Practice address
155 Wilson Ave
Washington Hospital
Washington, PA 15301-3336
Phone
(724) 223-3342
Fax
(610) 617-6280
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS013781 PA Primary
Family Medicine Physician 207Q00000X OS013781 PA

Addresses

Primary practice location

155 Wilson Ave
Washington Hospital
Washington, PA 15301-3336

Mailing address

155 Wilson Ave
Washington Hospital
Washington, PA 15301-3336
Phone (724) 223-3342

Other names 1

  • Julie Renee Coffman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN, OK, IL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20190325000597 MI Practitioner - Family Practice 8820191380
I20190416000294 IN Practitioner - Family Practice 8820191380
I20190507000869 OK Practitioner - Family Practice 8820191380
I20190514002816 IL Practitioner - Family Practice 8820191380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Oklahoma Emergency Medicine CurrentSince Mar 21, 2019 Accepting new patients
Medexpress Urgent Care Texas, P.a. Emergency Medicine Past Accepting new patients
Washington Hospital Emergency Medicine Past Accepting new patients
Medexpress Urgent Care, PC - Monaca Emergency Medicine Past Accepting new patients

Locations

3428 NW Cache Rd
Lawton, OK 73505
Phone (580) 595-7207

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1225194178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WILSON AVE",
            "address_2": "WASHINGTON HOSPITAL",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153013336",
            "telephone_number": "724-223-3342",
            "fax_number": "610-617-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WILSON AVE",
            "address_2": "WASHINGTON HOSPITAL",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153013336",
            "telephone_number": "724-223-3342",
            "fax_number": "610-617-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "JULIEANNE",
        "middle_name": "RENEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS013781",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS013781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "COFFMAN",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.