Angela Laverne Watkins

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704222141 Issued in MI

Practice address

22250 Providence Dr Ste 406
Southfield, MI 48075-6212

Phone

(248) 557-9010

Fax

(248) 557-3655

NPI assigned

Nov 20, 2019

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Pragnesh Patel PLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Sterling Heights, MI
  • NPI 1164068227
  Medicare reassignment NPD
• Michigan Kidney Consultants, P.C.

  • Nephrology Physician
  • Sterling Heights, MI
  • NPI 1831130723
  Medicare reassignment NPD
• Prasad Mikkilineni MD PLLC

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1629582226
  Medicare reassignment NPD

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1295371649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17030 CARRIAGE WAY",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481686602",
            "telephone_number": "313-949-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 406",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756212",
            "telephone_number": "248-557-9010",
            "fax_number": "248-557-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "ANGELA",
        "middle_name": "LAVERNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704222141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Washington
• Tomeika Washington
• Wilshawnna Washington
• Teaonna Waterhouse
• Sharon Mary Waterstradt, OTR
• Brandy Watkins
• Laraisha Watkins
• Myra Jasmine Watkins
• Nina Maria Watkins
• Samantha Watkins

• Nurse Practitioner in Southfield, MI
• Providers in Southfield, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.