Active NPI
Justin Watts
- Contractor
- Norfolk, NE
National Provider Identifier
1407712185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 54690-25
- Practice address
- 507 W Omaha Ave
Norfolk, NE 68701-6244 - Phone
- (405) 410-6402
- NPI assigned
- Dec 26, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 54690-25 | NE | Primary |
Addresses
Primary practice location
507 W Omaha Ave
Norfolk, NE 68701-6244
Mailing address
507 W Omaha Ave
Norfolk, NE 68701-6244
Phone (405) 410-6402
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54690-25 | NE | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766707200000",
"number": "1407712185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 W OMAHA AVE",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687016244",
"telephone_number": "405-410-6402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 W OMAHA AVE",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687016244",
"telephone_number": "405-410-6402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "JUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-12-26",
"last_updated": "2025-12-26",
"certification_date": "2025-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NE",
"license": "54690-25",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.