Individual provider Active NPI

Linda Lucky Watson X, RN

  • Community Health Registered Nurse
  • Scottsdale, AZ
National Provider Identifier
1396178992
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN111928 Issued in AZ
Practice address
11545 N Frank Lloyd Wright Blvd
Apt 2050
Scottsdale, AZ 85259-3141
Phone
(904) 945-5009
NPI assigned
Aug 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 246661-1 NY
Community Health Registered Nurse 163WC1500X RN111928 AZ Primary
General Practice Registered Nurse 163WG0000X RN111928 AZ
Home Health Registered Nurse 163WH0200X RN111928 AZ

Addresses

Primary practice location

11545 N Frank Lloyd Wright Blvd
Apt 2050
Scottsdale, AZ 85259-3141

Mailing address

11545 N Frank Lloyd Wright Boulavard
Apt 2050
Scottsdale, AZ 85259-2717
Phone (904) 945-5009

Other identifiers 2

IdentifierTypeStateIssuer
AZRN111928OtherAZARIZONA REGISTERED NURSE LICENSE NUMBER AZ RN 111928
246661-1OtherNYREGISTERED NIRSE LICENSE

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

LicenseStateTypeSpecialty
246661-1NYMDCase Management Registered Nurse
RN111928AZMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1396178992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545 N FRANK LLOYD WRIGHT BOULAVARD",
            "address_2": "APT 2050",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852592717",
            "telephone_number": "904-945-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11545 N FRANK LLOYD WRIGHT BLVD",
            "address_2": "APT 2050",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593141",
            "telephone_number": "904-945-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LINDA",
        "middle_name": "LUCKY",
        "name_prefix": "Ms.",
        "name_suffix": "X",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NY",
            "license": "246661-1",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "AZ",
            "license": "RN111928",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AZ",
            "license": "RN111928",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "AZ",
            "license": "RN111928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA REGISTERED NURSE LICENSE NUMBER AZ RN 111928",
            "identifier": "AZRN111928",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NIRSE LICENSE",
            "identifier": "246661-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.

Verify at the official NPI Registry.