Individual provider Active NPI

Stacy Nicole Watts, FNP-C

  • Nurse Practitioner
  • Rome, GA
National Provider Identifier
1225819006
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN287079 Issued in GA
Practice address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone
(762) 235-2330
Fax
(706) 236-6360
NPI assigned
Oct 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN287079 GA Primary

Addresses

Primary practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stacy.watts.1@1498.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20231130000424 GA Practitioner - Nurse Practitioner 1850749946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (762) 235-2495

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
65.74
Promoting interoperability
100
Improvement activities
40
Cost
78.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN287079GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC CurrentSince Nov 13, 2023 Accepting new patients
Harbin Clinic, LLC CurrentSince Nov 13, 2023 Accepting new patients
Harbin Clinic, LLC Current Accepting new patients

Locations

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

Interoperability endpoints

  • Direct secure messaging: swatts3004883@carolinashealthcaresystem.direct-ci.com

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 2

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": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1225819006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "762-235-2330",
            "fax_number": "706-236-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN287079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stacy.watts.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1825 Martha Berry Blvd NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.