Individual provider Active NPI

Theresa Watts, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1225318645
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3009314 Issued in KY
Practice address
3701 Landsdowne Dr
Ashland, KY 41102-5422
Phone
(606) 324-3005
Fax
(606) 329-1530
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1061923 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3009314 KY Primary

Addresses

Primary practice location

3701 Landsdowne Dr
Ashland, KY 41102-5422

Mailing address

PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588

Other practice location 1

321 E Main St
Morehead, KY 40351-1671
Phone (606) 784-4161

Other identifiers 1

IdentifierTypeStateIssuer
30610026MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514001081 KY Practitioner - Nurse Practitioner 9032439021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways IncGroup PAC ID 1254239171, 60 clinicians

Practice addresses (Care Compare)

840 Interstate Dr
Grayson, KY 41143-1768
Phone (606) 474-5151

Hospital & facility affiliations

  • King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1061923KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways, Inc CurrentSince Apr 1, 2015 Accepting new patients
Pathways Inc CurrentSince Apr 1, 2015 Accepting new patients

Locations

3701 Landsdowne Dr
Ashland, KY 41102
Phone (606) 324-3005

201 22nd St
Ashland, KY 41101
Phone (606) 324-1141

70 Main St
Frenchburg, KY 40322
Phone (606) 768-2131

840 Interstate Dr
Grayson, KY 41143
Phone (606) 474-5151

57 Dora Ln
Greenup, KY 41144
Phone (606) 473-7333

60 Professional Park Dr
Louisa, KY 41230
Phone (606) 356-0129

321 E Main St
Morehead, KY 40351
Phone (606) 784-4161

300 Foxglove Dr
Mt Sterling, KY 40353
Phone (800) 562-8909

374 N Ky 7
Sandy Hook, KY 41171
Phone (606) 738-6163

767 Main St
West Liberty, KY 41472
Phone (606) 743-3139

Organizations & group practices 2

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 1

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": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1225318645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050790",
            "telephone_number": "606-329-8588",
            "fax_number": "606-329-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 LANDSDOWNE DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411025422",
            "telephone_number": "606-324-3005",
            "fax_number": "606-329-1530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 E Main St",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403511671",
            "country_code": "US",
            "telephone_number": "606-784-4161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "THERESA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1061923",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3009314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.