Active NPI
Andrew Bruce Watson, PTA
- Physical Therapy Assistant
- Omaha, NE
National Provider Identifier
1275703282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7686
- Practice address
- 12020 Pacific St
Omaha, NE 68154-3507 - Phone
- (800) 259-9897
- NPI assigned
- Mar 5, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 7686 | MA | Primary |
Addresses
Primary practice location
12020 Pacific St
Omaha, NE 68154-3507
Mailing address
151 Stanton Ave
Auburndale, MA 02466-3005
Phone (857) 404-6432
Other practice location 1
27240 Haggerty Rd Ste E-15
Farmington Hills, MI 48331-5716
Phone (248) 488-0350
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7686 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564358400000",
"number": "1275703282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 STANTON AVE",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024663005",
"telephone_number": "857-404-6432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12020 PACIFIC ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681543507",
"telephone_number": "800-259-9897"
}
],
"practiceLocations": [
{
"address_1": "27240 Haggerty Rd Ste E-15",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483315716",
"country_code": "US",
"telephone_number": "248-488-0350",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "ANDREW",
"middle_name": "BRUCE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-05",
"last_updated": "2019-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "7686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.