Samuel M. Watts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R5A74 Issued in MO

Practice address

1319 S Landrum St
Suite a
Mount Vernon, MO 65712-1910

Phone

(417) 466-2001

Fax

(417) 466-2005

NPI assigned

Oct 11, 2006

Last updated

Jul 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: swatts1298@directb.mercy.net

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1427147438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 S LANDRUM ST",
            "address_2": "SUITE A",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121910",
            "telephone_number": "417-466-2001",
            "fax_number": "417-466-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "SAMUEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R5A74",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201690013",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kusai A Umran, MD
• Megan Caroline Vanderbush, COTA
• Gail M Vaughn, RPH
• Wal-Mart Stores East LP (Walmart Pharmacy 10-7249)
• Mark Vincent Walters, D.C.
• Nicole Welch, OTR/L
• Weldy Family Chiropractic LLC (Mt. Vernon Spine)
• Auston Weldy
• David Michael Werner, O.D.
• Kendra R White, PHARMD

• Family Medicine Physician in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.