Active NPI
Kim Davis Watson, MED
- Counselor
- Wilson, NC
National Provider Identifier
1265620330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 9077
- Practice address
- 1716 Wilshire Blvd N
Wilson, NC 27893-1856 - Phone
- (252) 243-5793
- Fax
- (252) 243-7486
- NPI assigned
- Oct 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 9077 | NC | Primary |
Addresses
Primary practice location
1716 Wilshire Blvd N
Wilson, NC 27893-1856
Mailing address
1716 Wilshire Blvd N
Wilson, NC 27893-1856
Phone (252) 243-5793
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9077 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192320000000",
"number": "1265620330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 WILSHIRE BLVD N",
"city": "WILSON",
"state": "NC",
"postal_code": "278931856",
"telephone_number": "252-243-5793",
"fax_number": "252-243-7486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 WILSHIRE BLVD N",
"city": "WILSON",
"state": "NC",
"postal_code": "278931856",
"telephone_number": "252-243-5793",
"fax_number": "252-243-7486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "KIM",
"middle_name": "DAVIS",
"credential": "MED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-14",
"last_updated": "2007-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "9077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.