Active NPI
Bonnie Yvonne Watkins, PA
- Anatomic Pathology Physician
- Lawrenceville, GA
National Provider Identifier
1376305698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 1536
- Practice address
- 1000 Medical Center Blvd
Lawrenceville, GA 30046-7694 - Phone
- (678) 312-4526
- Fax
- (770) 682-2219
- NPI assigned
- Jan 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 1536 | GA | Primary |
Addresses
Primary practice location
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Mailing address
5462 Whittlesey Blvd Apt B102
Columbus, GA 31909-2188
Phone (602) 418-2518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1536 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1376305698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5462 WHITTLESEY BLVD APT B102",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319092188",
"telephone_number": "602-418-2518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MEDICAL CENTER BLVD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467694",
"telephone_number": "678-312-4526",
"fax_number": "770-682-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "BONNIE",
"middle_name": "YVONNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-24",
"last_updated": "2024-01-24",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "GA",
"license": "1536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.