Individual provider Active NPI

Cynthia Anice Watson, M.S. C.G.G.

  • Genetic Counselor (M.S.)
  • St Petersburg, FL
National Provider Identifier
1407280001
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
Practice address
877 Executive Center Dr W
Suite 206
St Petersburg, FL 33702-2460
Phone
(760) 670-4551
NPI assigned
Aug 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X TN Primary

Addresses

Primary practice location

877 Executive Center Dr W
Suite 206
St Petersburg, FL 33702-2460

Mailing address

877 Executive Center Dr W
Suite 206
St Petersburg, FL 33702-2460
Phone (760) 670-4551

Other names 1

  • Cynthia Anice Freeman Former name

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
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Informeddna Medical Group, P.a. Genetic Counselor, Ms PastSince Oct 1, 2019 Accepting new patients
Informed Medical Decisions, Inc. Genetic Counselor, Ms Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1407280001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 EXECUTIVE CENTER DR W",
            "address_2": "SUITE 206",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022460",
            "telephone_number": "760-670-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 EXECUTIVE CENTER DR W",
            "address_2": "SUITE 206",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022460",
            "telephone_number": "760-670-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CYNTHIA",
        "middle_name": "ANICE",
        "credential": "M.S. C.G.G.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "FREEMAN",
            "middle_name": "ANICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.