Individual provider Active NPI

Marygrace Fattaleh Watts, APRN-CNP, FNP-BC

  • Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1265306203
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
123637 Issued in WV
Practice address
1115 20TH St
Huntington, WV 25703-2071
Phone
(304) 399-4121
Fax
(304) 399-4126
NPI assigned
Oct 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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 123637 WV Primary

Addresses

Primary practice location

1115 20TH St
Huntington, WV 25703-2071

Mailing address

1115 20TH St Ste 101
Huntington, WV 25703-2071
Phone (304) 399-4121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20260107000826 WV Practitioner - Nurse Practitioner 1456847730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians and Surgeons, IncGroup PAC ID 2961315734, 379 clinicians

Practice addresses (Care Compare)

1115 20TH St
Huntington, WV 25703-2071

1600 Medical Ctr Dr
Huntington, WV 25701-3655

Hospital & facility affiliations

  • Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123637WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Nov 1, 2025 Accepting new patients
University Physicians & Surgeons, Inc CurrentSince Nov 1, 2025 Accepting new patients
CHH Center for Surgical Weight Control Past Accepting new patients

Locations

1115 20th St
Ste 101
Huntington, WV 25703
Phone (304) 399-4121

1115 20th St
Huntington, WV 25703
Phone (304) 399-4121

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

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 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": "1759363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1265306203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 20TH ST STE 101",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032071",
            "telephone_number": "304-399-4121",
            "fax_number": "304-399-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032071",
            "telephone_number": "304-399-4121",
            "fax_number": "304-399-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "MARYGRACE",
        "middle_name": "FATTALEH",
        "credential": "APRN-CNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-02",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "123637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.