Individual provider Active NPI

Brianna Nicole Watkins, PA-C

  • Physician Assistant
  • Flowood, MS
National Provider Identifier
1225890684
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1040 River Oaks Dr Ste 103
Flowood, MS 39232-9531
Phone
(601) 948-6540
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MS Primary

Addresses

Primary practice location

1040 River Oaks Dr Ste 103
Flowood, MS 39232-9531

Mailing address

1040 River Oaks Dr Ste 103
Flowood, MS 39232-9531
Phone (601) 948-6540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240430002552 MS Practitioner - Physician Assistant 1153761762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Urogyn LLCGroup PAC ID 7517197718, 9 clinicians

Practice addresses (Care Compare)

1040 River Oaks Dr
Flowood, MS 39232-9531
Phone (601) 948-6540

111 Colony Crossing Way
Suite 250
Madison, MS 39110-6832
Phone (601) 326-6401

Hospital & facility affiliations

  • Merit Health River Oaks Hospital, Flowood, MS, CCN 250138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ovation Womens Wellness LLC PastSince Aug 30, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brianna.watkins.1@30135.direct.athenahealth.com

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1225890684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 103",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329531",
            "telephone_number": "601-948-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 103",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329531",
            "telephone_number": "601-948-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "BRIANNA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.