NPIMap

Individual provider Active NPI

Carter Watters, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1437169844
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18640 Issued in MS
Practice address
1850 Chadwick Dr
Jackson, MS 39204-3404
Phone
(601) 376-2022
NPI assigned
Aug 8, 2006
Last updated
Feb 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18640 MS Primary
Hospitalist Physician 208M00000X 18640 MS

Addresses

Primary practice location

1850 Chadwick Dr
Jackson, MS 39204-3404

Mailing address

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-2022

Other identifiers 1

IdentifierTypeStateIssuer
01532506MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020001056 MS Practitioner - Internal Medicine 4880655117 Reassigns benefits to 2 organizations
Practice locations: Jackson, MS

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Hma Hospitalists LLCGroup PAC ID 5991972077, 55 clinicians

Practice addresses (Care Compare)

350 Crossgates Blvd
Brandon, MS 39042-2601
Phone (601) 824-8501

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Hma Hospitalists, LLC Hospitalist CurrentSince Jan 1, 2012 Accepting new patients
Reservoir Family Medical Clinic, PA Current Accepting new patients
River Oaks Mangement CurrentSince Oct 1, 2006 Accepting new patients
River Oaks Management Company LLC Internal Medicine Current Accepting new patients
Careplus Lakeview Family Medicine CurrentSince Oct 1, 2006 Accepting new patients
Jackson Hma LLC Past Accepting new patients
Select Specialty Hospital - Jackson Inc Past Accepting new patients
Peter J Jensen MD PC Past Accepting new patients

Locations

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

1850 Chadwick Dr
Fl 5
Jackson, MS 39204
Phone (601) 376-1005

5903 Ridgewood Rd
Jackson, MS 39211
Phone (601) 376-2022

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1437169844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "601-376-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "601-376-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "CARTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "18640",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "18640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01532506",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.