Active NPI
Derek Philip Watson, MD
- Physical Medicine & Rehabilitation Physician
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 2008-00177
- Practice address
- 11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375 - Phone
- (919) 562-9410
- Fax
- (919) 562-2948
- NPI assigned
- Aug 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2008-00177 | NC | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 2008-00177 | NC | Primary |
Addresses
Primary practice location
11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375
Mailing address
PO Box 1107
Wake Forest, NC 27588-1107
Phone (919) 562-9410
Other practice location 1
6602 Knightdale Blvd Ste 310
Knightdale, NC 27545-6526
Phone (919) 562-9410
Other practice location 2
200 W Parkview Dr Ste B
Henderson, NC 27536-5958
Phone (919) 562-9410
Other practice location 3
103 Professional Park Ste A
Oxford, NC 27565-2581
Phone (919) 562-9410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Brody School of Medicine at East Carolina University, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proactive Therapy of North Carolina IncLegacy Healthcare Services Inc
Practice addresses (Care Compare)
11221 Galleria Ave
Suite 101
Raleigh, NC 27614-8137
Phone (919) 562-9410
2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818
2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600
Hospital & facility affiliations
- Wakemed, Raleigh Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.17 of 100
- Quality
- 77.12
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008-00177 | NC | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Specialists of North Carolina, P.a. | Orthopaedic Surgery | Current | Accepting new patients |
| Orthopaedic Specialists of North Carolina, P.a. | Orthopaedic Surgery | Current | Accepting new patients |
Locations
200 W Parkview Dr
#B
Henderson, NC 27536
6602 Knightdale Blvd
Ste 310
Knightdale, NC 27545
103 Professional Park
Ste A
Oxford, NC 27565
Phone (919) 693-7108
5838 Six Forks Rd
Ste 300
Raleigh, NC 27609
Phone (919) 782-5954
5838 Six Forks Rd
Ste 100
Raleigh, NC 27609
11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247
5838 Six Forks Rd
Raleigh, NC 27609
Phone (919) 847-1100
11221 Galleria Ave
#101
Raleigh, NC 27614
Phone 9195629410213
1936 Golden Spur Ln
Wendell, NC 27591
Interoperability endpoints
- derek.watson.1@12529.direct.athenahealth.com
- dwatson11539@direct.unc.nchie.net
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.
-
- Orthopaedic Surgery Physician
- Raleigh, NC
- NPI 1649327750
-
- Orthopaedic Surgery Physician
- Raleigh, NC
- NPI 1447553870
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Raleigh, NC
- NPI 1780446302
-
- General Acute Care Hospital
- Raleigh, NC
- NPI 1972579837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551225600000",
"number": "1255524435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1107",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275881107",
"telephone_number": "919-562-9410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 GOVERNOR MANLY WAY STE 309",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276147375",
"telephone_number": "919-562-9410",
"fax_number": "919-562-2948"
}
],
"practiceLocations": [
{
"address_1": "6602 Knightdale Blvd Ste 310",
"address_purpose": "LOCATION",
"city": "Knightdale",
"state": "NC",
"postal_code": "275456526",
"country_code": "US",
"telephone_number": "919-562-9410",
"fax_number": "919-562-2948",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 W Parkview Dr Ste B",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NC",
"postal_code": "275365958",
"country_code": "US",
"telephone_number": "919-562-9410",
"fax_number": "919-562-2948",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "103 Professional Park Ste A",
"address_purpose": "LOCATION",
"city": "Oxford",
"state": "NC",
"postal_code": "275652581",
"country_code": "US",
"telephone_number": "919-562-9410",
"fax_number": "919-562-2948",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "DEREK",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-22",
"last_updated": "2019-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NC",
"license": "2008-00177",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NC",
"license": "2008-00177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.