Individual provider Active NPI

Jerome Thomas Watson, MD

  • Physical Medicine & Rehabilitation Physician
  • Statesville, NC
National Provider Identifier
1336144138
Registry record updated Feb 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
9800413 Issued in NC
Practice address
293 Old Mocksville Rd
Statesville, NC 28625-1930
Phone
(704) 872-8711
Fax
(704) 872-5866
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 9800413 NC Primary

Addresses

Primary practice location

293 Old Mocksville Rd
Statesville, NC 28625-1930

Mailing address

766 Hartness Rd Ste B
Statesville, NC 28677-3485
Phone (704) 873-5667

Other identifiers 2

IdentifierTypeStateIssuer
891129MMedicaidNC
498003002OtherNCDMERC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jerome.watson@direct.carolinaspecialty.nextgenshare.com

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000527 NC Practitioner - Physical Medicine and Rehabilitation 8224160304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Virginia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians
Carolina Specialty Care, PAGroup PAC ID 8729989173, 5 clinicians

Practice addresses (Care Compare)

293 Old Mocksville Rd
Statesville, NC 28625-1930
Phone (704) 872-8711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.49 of 100Reported as group
Quality
92.38
Improvement activities
40
Cost
74.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9800413NCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince Jan 1, 2026 Accepting new patients
Iredell Physician Network LLC CurrentSince Jan 1, 2026 Accepting new patients
Carolina Specialty Care, PA CurrentSince Jun 26, 2003 Accepting new patients
Iredell Physician Network, LLC PastSince Mar 26, 2023 Accepting new patients
Iredell Physician Network LLC Past Accepting new patients

Locations

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

124 Sunset Hill Rd
Statesville, NC 28625
Phone (704) 872-8711

766 Hartness Rd
Ste B
Statesville, NC 28677

293 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 872-8711

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771027200000",
    "number": "1336144138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 HARTNESS RD STE B",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773485",
            "telephone_number": "704-873-5667",
            "fax_number": "704-883-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-872-8711",
            "fax_number": "704-872-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JEROME",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-02-14",
        "certification_date": "2026-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "9800413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891129M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "498003002",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jerome.watson@direct.carolinaspecialty.nextgenshare.com",
            "affiliation": "N",
            "address_1": "293 Old Mocksville Road",
            "city": "Statesville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286251903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.