Individual provider Active NPI

David D Watson, MD

  • Emergency Medicine Physician
  • Delaware, OH
National Provider Identifier
1265496103
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35060740 Issued in OH
Practice address
561 W Central Ave
Delaware, OH 43015-1410
Phone
(740) 615-1153
Fax
(740) 615-1150
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35060740 OH Primary

Addresses

Primary practice location

561 W Central Ave
Delaware, OH 43015-1410

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Other identifiers 3

IdentifierTypeStateIssuer
000000317009OtherOHBC/BS PROVIDER #GRADY
0823685MedicaidOH
P00072905OtherOHRRMEDICARE # AT GRADY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001161 OH Practitioner - Emergency Medicine 1658275615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20442WVMDLicensed Vocational Nurse
35060740OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Emergency Care Services, Inc Emergency Medicine CurrentSince May 16, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Ohio Emergency Professionals Inc Emergency Medicine Past Accepting new patients

Locations

561 W Central Ave
Delaware, OH 43015
Phone (614) 566-9983

651 W Marion Rd
Mount Gilead, OH 43338
Phone (419) 946-5015

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1265496103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 W CENTRAL AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151410",
            "telephone_number": "740-615-1153",
            "fax_number": "740-615-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DAVID",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35060740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #GRADY",
            "identifier": "000000317009",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0823685",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE # AT GRADY",
            "identifier": "P00072905",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.