Kenna Riley Watson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

50 Emma Dr
Campobello, SC 29322-9295

Phone

(910) 315-3044

NPI assigned

May 15, 2023

Last updated

May 15, 2023By the provider in NPPES

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 NC

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Rutherford Physician Practices LLCGroup PAC ID 0345466561, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rutherford Regional Medical Center Hospital, Rutherfordton, NC, CCN 340013
• Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenna.watson.1@9573.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DLP Rutherford Physician Practices LLC

  • Family Medicine Physician
  • Forest City, NC
  • NPI 1962821322
  Medicare reassignment Care Compare group
• Asheville Heart PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Asheville, NC
  • NPI 1376690412
  Medicare reassignment
• DLP Rutherford Physician Practices LLC

  dba Rutherford Family Care

  • Rural Health Clinic/Center
  • Rutherfordton, NC
  • NPI 1720849391
  NPD
• DLP Rutherford Physician Practices LLC

  dba Rutherford Children's Care

  • Rural Health Clinic/Center
  • Forest City, NC
  • NPI 1912684473
  NPD
• DLP Rutherford Physician Practices LLC

  dba Rutherford Orthopaedics

  • Orthopaedic Surgery Physician
  • Rutherfordton, NC
  • NPI 1275943698

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atrium Health Hospitals Inc

  dba Atrium Health Cleveland

  • General Acute Care Hospital
  • Shelby, NC
  • NPI 1669348991
  Care Compare affiliation
• DLP Rutherford Regional Health System, LLC

  dba Rutherford Regional Health System

  • General Acute Care Hospital
  • Rutherfordton, NC
  • NPI 1245321181
  Care Compare affiliation

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1306536172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 EMMA DR",
            "city": "CAMPOBELLO",
            "state": "SC",
            "postal_code": "293229295",
            "telephone_number": "910-315-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EMMA DR",
            "city": "CAMPOBELLO",
            "state": "SC",
            "postal_code": "293229295",
            "telephone_number": "910-315-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KENNA",
        "middle_name": "RILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Skellie, RDH
• Southeast Regional Virtual Imaging Consulting Enterprise PA
• Spartanburg County District One Schools
• Spartanburg School District One
• Katherine Vickery, MS, CCC/SLP

• Physician Assistant in Campobello, SC
• Providers in Campobello, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.

Verify at the official NPI Registry.