Individual provider Active NPI

Debra Sue Watson, ARNP

  • Family Nurse Practitioner
  • Fuquay Varina, NC
National Provider Identifier
1255627253
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5018078 Issued in NC
Practice address
400 Attain St Ste 202
Fuquay Varina, NC 27526-2702
Phone
(541) 425-7545
Fax
(541) 425-5557
NPI assigned
Jun 28, 2011
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5018078 NC Primary

Addresses

Primary practice location

400 Attain St Ste 202
Fuquay Varina, NC 27526-2702

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 237-1337

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925000574 NC Practitioner - Nurse Practitioner 9436329950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

400 Attain St
Suite 202
Fuquay Varina, NC 27526-2702
Phone (984) 377-8675

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Jun 27, 2023 Accepting new patients
Raleigh Medical Group, PA PastSince May 7, 2023 Accepting new patients
Freedom Healthcare Inc PastSince May 1, 2022 Accepting new patients

Locations

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

400 Attain St
Ste 202
Fuquay Varina, NC 27526
Phone (984) 377-8675

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

Interoperability endpoints

  • Direct secure messaging: dwatson37814@fastmed.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1255627253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337",
            "fax_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ATTAIN ST STE 202",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262702",
            "telephone_number": "541-425-7545",
            "fax_number": "541-425-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DEBRA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.