Individual provider Active NPI

Holly A Watson, MMS, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1376163592
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003219A Issued in IN
Practice address
2 Miranova PL Ste 500
Columbus, OH 43215-7052
Phone
(614) 321-9743
NPI assigned
Apr 17, 2020
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003219A IL
Physician Assistant 363A00000X 10003219A IN Primary
Medical Physician Assistant 363AM0700X NU
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2 Miranova PL Ste 500
Columbus, OH 43215-7052

Mailing address

2 Miranova PL Ste 500
Columbus, OH 43215-7052

Other practice location 1

17840 Cumberland Rd
Noblesville, IN 46060-5409
Phone (317) 574-1254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20220321001617 IN Practitioner - Physician Assistant 2769877299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

697 Pro Med LN
Carmel, IN 46032-5323

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003219AILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allcare Rheumatology, LLC PastSince Nov 26, 2012 Accepting new patients
Andhealth LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hollyautumn.watson.p40@direct.aara1.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1376163592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MIRANOVA PL STE 500",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MIRANOVA PL STE 500",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157052",
            "telephone_number": "614-321-9743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17840 Cumberland Rd",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460605409",
            "country_code": "US",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "HOLLY",
        "middle_name": "A",
        "credential": "MMS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "10003219A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003219A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.