Active NPI
Jennifer Smith Watters, R.N.
- Registered Nurse
- Union, SC
National Provider Identifier
1376987255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 205667
- Practice address
- 120 Lakeside Dr
Union, SC 29379-1939 - Phone
- (864) 429-1735
- Fax
- (864) 429-2828
- NPI assigned
- Apr 23, 2013
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 205667 | SC | Primary |
Addresses
Primary practice location
120 Lakeside Dr
Union, SC 29379-1939
Mailing address
120 Lakeside Dr
Union, SC 29379-1939
Phone (864) 429-1735
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205667 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1376987255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 LAKESIDE DR",
"city": "UNION",
"state": "SC",
"postal_code": "293791939",
"telephone_number": "864-429-1735",
"fax_number": "864-429-2828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 LAKESIDE DR",
"city": "UNION",
"state": "SC",
"postal_code": "293791939",
"telephone_number": "864-429-1735",
"fax_number": "864-429-2828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTERS",
"first_name": "JENNIFER",
"middle_name": "SMITH",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-23",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "205667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.