Individual provider Active NPI

Danielle M Watters, MS, ACSM-CEP

  • Clinical Exercise Physiologist
  • Vernon, CT
National Provider Identifier
1407555774
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
Practice address
31 Union St
Vernon, CT 06066-3126
Phone
(860) 872-5157
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X NU Primary

Addresses

Primary practice location

31 Union St
Vernon, CT 06066-3126

Mailing address

393 Linwood Cemetery Rd
Colchester, CT 06415-1149
Phone (860) 301-2288

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

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1407555774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 LINWOOD CEMETERY RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151149",
            "telephone_number": "860-301-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 UNION ST",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663126",
            "telephone_number": "860-872-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "MS, ACSM-CEP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.