Kenneth Dale Watkins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01028715 Issued in IN

Practice address

108 E Hospital Dr
Winchester, IN 47394-2223

Phone

(765) 584-1639

Fax

(765) 584-4711

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN2 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 2

Rural health clinic certification: CCN 153864

Legal name

KENNETH D WATKINS MD

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Oct 21, 2002

Last certification

Jun 15, 2021

Ownership / control type

1A

Organization structure

Sole ProprietorProprietary

Enrollment address

108 E Hospital Dr
Winchester, IN 47394-2223

Specialty

General Practice

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Home Health Angels LLC Home health agency, Winchester, IN, CCN 157610
• United Home Health Care LLC Home health agency, Muncie, IN, CCN 157699
• Keystone Hospice Hospice, Indianapolis, IN, CCN 151596
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Ascension St Vincent Randolph Hospital, Winchester, IN, CCN 151301
• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089
• Reid Health Hospital, Richmond, IN, CCN 150048
• Pineknoll Rehabilitation Centre Nursing home, Winchester, IN, CCN 155527

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.watkins.1@23643.direct.athenahealth.com

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Alice Pauline Watkins, FNP

  • Family Nurse Practitioner
  • Winchester, IN
  • NPI 1497805725

  W-2 Managing Employee

  CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Witham Memorial Hospital

  • Skilled Nursing Facility
  • Winchester, IN
  • NPI 1275732950

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alice Pauline Watkins, FNP

  • Family Nurse Practitioner
  • Winchester, IN
  • NPI 1497805725
  Medicare reassignment

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.

• Winchester Family Medicine

  • Family Medicine Physician
  • Winchester, IN
  • NPI 1407710676
  NPD

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

• Home Health Angels LLC

  • Home Health Agency
  • Winchester, IN
  • NPI 1467692400
  Care Compare affiliation
• Hospice Company Inc

  • Community Based Hospice Care Agency
  • Indianapolis, IN
  • NPI 1043244254
  Care Compare affiliation
• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation
• Reid Hospital & Health Care Services, Inc

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation
• St. Vincent Randolph Hospital, Inc.

  • Critical Access Hospital
  • Winchester, IN
  • NPI 1609826783
  Care Compare affiliation
• United Home Health Care LLC

  • Home Health Agency
  • Muncie, IN
  • NPI 1033594429
  Care Compare affiliation
• Witham Memorial Hospital

  • Skilled Nursing Facility
  • Winchester, IN
  • NPI 1275732950

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1235121963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E HOSPITAL DR",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473942223",
            "telephone_number": "765-584-1639",
            "fax_number": "765-584-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E HOSPITAL DR",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473942223",
            "telephone_number": "765-584-1639",
            "fax_number": "765-584-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "KENNETH",
        "middle_name": "DALE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01028715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100127560A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Turner
• Joseph P Vancamp, PT
• Volunteers of America of Indiana, Inc
• Wal-Mart Stores East LP
• Alice Pauline Watkins, FNP
• Sue H Webster, M.D.
• Daniel Lloyd Wegg, MD
• Whitewater Eye Centers LLC
• John Richard Williams, D.D.S.
• Winchester Community Pharmacy

• Family Medicine Physician in Winchester, IN
• Providers in Winchester, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.