Active NPI
Stephen D. Watson, M.D., PHD.
- Pain Medicine (Anesthesiology) Physician
- Easley, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 93018
- Practice address
- 201A Richard St.
Easley, SC 29640 - Phone
- (864) 343-4190
- NPI assigned
- Aug 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | 35-06-3329 | OH | |
| Interventional Pain Medicine Physician | 208VP0014X | ME105674 | FL | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 93018 | SC | Primary |
Addresses
Primary practice location
201A Richard St.
Easley, SC 29640
Mailing address
10903 Sheldon Rd
Tampa, FL 33626-4702
Phone (813) 920-3022
Other practice location 1
10903 Sheldon Rd
Tampa, FL 33626-4702
Phone (813) 920-3022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0884691 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pain Management
- Education
- Wright State University Boonshoft School of Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13055 Summerfield Square Dr
Riverview, FL 33578-7402
Phone (813) 741-2473
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93018 | SC | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summerfield Medical Clinic MD PA | Current | Accepting new patients | |
| Premier Pain Solutions PLLC | Pain Medicine | Current | Accepting new patients |
| Premier Pain Solutions PLLC | Pain Medicine | Current | Accepting new patients |
Locations
13055 Summerfield Square Dr
Riverview, FL 33578
Phone (813) 234-9409
13055 Summerfield Square Dr
#D
Riverview, FL 33578
Phone (813) 741-2473
201 Richard St
#A
Easley, SC 29640
Phone (828) 221-0121
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.
-
- Pain Medicine (Anesthesiology) Physician
- Asheville, NC
- NPI 1710336243
SC
-
- Multi-Specialty Clinic/Center
- Riverview, FL
- NPI 1568780492
-
- Pain Medicine (Anesthesiology) Physician
- Columbus, NC
- NPI 1366923898
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": "1728000000000",
"number": "1265625321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10903 SHELDON RD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336264702",
"telephone_number": "813-920-3022",
"fax_number": "813-920-7666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201A RICHARD ST.",
"city": "EASLEY",
"state": "SC",
"postal_code": "29640",
"telephone_number": "864-343-4190"
}
],
"practiceLocations": [
{
"address_1": "10903 Sheldon Rd",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336264702",
"country_code": "US",
"telephone_number": "813-920-3022",
"fax_number": "813-920-7666",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "STEPHEN",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D., PHD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-22",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "OH",
"license": "35-06-3329",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "FL",
"license": "ME105674",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "SC",
"license": "93018",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0884691",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Easley, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.