Maryjo A Watkins, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

10681 Issued in TN

Practice address

155 Memorial Dr
Anesthesia Dept
Pinehurst, NC 28374-8710

Phone

(910) 715-1235

NPI assigned

Sep 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• American Anesthesiology Group of Tennessee, P. C.

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1114927738

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesia and Pain Consultants,P.C.

  • Anesthesiology Physician
  • Johnson City, TN
  • NPI 1750399127

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesiology of Greenwood PA

  • Anesthesiology Physician
  • Greenwood, SC
  • NPI 1932189081
  NPD (past)
• Hamblen Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Morristown, TN
  • NPI 1821007485

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285628461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270230099",
            "telephone_number": "731-234-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "address_2": "ANESTHESIA DEPT",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "910-715-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "MARYJO",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "10681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3627252",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHC CARE ADMINISTRATORS",
            "identifier": "00013859",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF TN",
            "identifier": "4053056",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "278219",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74005992",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Ward
• David Royal Warden IV, M.D.
• Raymond G. Washington, MD
• Toni Anne Washington, MD
• Ashley Alexander Watkins, D.C.
• Courtney Michelle Watlington, PA
• Robert Maur Watt, M.D.
• Amara Camille Watters
• Amanda Korzep Watts, MD
• Joseph Watts

• All providers in Pinehurst, NC
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.