John Devin Blackwell Watson, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

28756 Issued in MS

Practice address

301 Fisher St
Keesler Afb, MS 39534-2508

Phone

(702) 460-1720

NPI assigned

Apr 5, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NM, SC, IL, VA4 enrollments

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 4

Specialty

Vascular SurgeryAlso: General Surgery

Education

George Washington University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
• Lewisgale Hospital Alleghany Hospital, Low Moor, VA, CCN 490126
• Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110
• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwatson332055@ahs.direct-ci.com
• Direct secure messaging: jwatson@direct.mhg.com
• Direct secure messaging: john.watson@hca6.eclinicaldirectplus.com

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.

• Lewis Gale Physicians LLC

  • Internal Medicine Physician
  • Salem, VA
  • NPI 1902977705
  Medicare reassignment Care Compare group NPD
• Lexington Health Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Columbia, SC
  • NPI 1710634753
  Medicare reassignment NPD
• Southwest Medical Associates, LLC

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment NPD
• Lexington Health Inc

  • Cardiovascular Disease Physician
  • West Columbia, SC
  • NPI 1083211312

  Vascular Surgery

  NPD
• Lexington Health Inc

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1942190988
  NPD
• Southwest Medical Associates, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1578255253
  NPD

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

• Carilion Medical Center

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation
• Columbia-Alleghany Regional Hospital Inc

  • Psychiatric Hospital Unit
  • Low Moor, VA
  • NPI 1285932962
  Care Compare affiliation
• Columbia-Alleghany Regional Hospital Inc

  • General Acute Care Hospital
  • Low Moor, VA
  • NPI 1538100029
  Care Compare affiliation
• Lewis-Gale Medical Center, LLC

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation
• Montgomery Regional Hospital Inc

  • General Acute Care Hospital
  • Blacksburg, VA
  • NPI 1275570376
  Care Compare affiliation

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1386969137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SCHOONER LN",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645049",
            "telephone_number": "210-238-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "702-460-1720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 MDG/SGCH",
            "address_2": "101 Bodin Circle",
            "address_purpose": "LOCATION",
            "city": "Travis AFB",
            "state": "CA",
            "postal_code": "945351800",
            "country_code": "US",
            "telephone_number": "707-423-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2728 Sunset Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694872",
            "country_code": "US",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JOHN DEVIN",
        "middle_name": "BLACKWELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101251335",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101251335",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "28756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01802274",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwatson160000@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 400",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwatson160000@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 400",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lynn Vix, M.D.
• Michael Norbert Wajdowicz, DDS
• John Waldron, MD
• Benjamin Mark Watson, MD
• James Matthew Watson, MD
• Daniel John Wattendorf, M.D.
• James Kevin Webb, CRNA
• Kimberly Weber
• Kathryn W. Weiss, CRNA
• Kathryn Welch, MCN, RDN, LD

• Vascular Surgery Physician in Keesler Afb, MS
• Providers in Keesler Afb, MS by specialty
• Vascular Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.