Individual provider Active NPI

Kathryn S Watson, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1417031733
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28145281A Issued in IN
Practice address
5734 Coventry LN
Fort Wayne, IN 46804-7141
Phone
(260) 436-7875
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 160617 OH
Certified Registered Nurse Anesthetist 367500000X 28145281A IN Primary
Certified Registered Nurse Anesthetist 367500000X NA-03760 OH

Addresses

Primary practice location

5734 Coventry LN
Fort Wayne, IN 46804-7141

Mailing address

5052 N Clinton St
Fort Wayne, IN 46825-5822
Phone (260) 408-2203

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
28145281AINMDCertified Registered Nurse Anesthetist
160617OHMDCertified Registered Nurse Anesthetist
NA-03760OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Lima Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Crna of Blanchard Valley LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Northeast Anesthesia Partners, Inc. Past Accepting new patients
Northern Indiana Anesthesia Services, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Associated Anesthesiologists of Toledo, Inc Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
BKC Pain Specialists, LLC Past Accepting new patients
Fauster Cameron Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1417031733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-408-2203",
            "fax_number": "260-408-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-436-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KATHRYN",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "160617",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28145281A",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA-03760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.