Individual provider Active NPI

Kaitlyn Anne Watson, M.D.

  • Family Medicine Physician
  • High Point, NC
National Provider Identifier
1437596574
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2016-00809 Issued in NC
Practice address
1814 Westchester Dr Ste 203
High Point, NC 27262-7369
Phone
(336) 702-1355
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2016-00809 NC Primary

Addresses

Primary practice location

1814 Westchester Dr Ste 203
High Point, NC 27262-7369

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-1311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719002361 NC Practitioner - Family Practice 7517197502 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-00809NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mediq Urgent Care PC CurrentSince Sep 21, 2019 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Mediq Urgent Care PC CurrentSince Sep 21, 2019 Accepting new patients
Cornerstone Health Care LLC Past Accepting new patients

Locations

5718 W Gate City Blvd
Greensboro, NC 27407
Phone (336) 738-1691

1912 Eastchester Dr
Ste 302
High Point, NC 27265
Phone (336) 438-2260

Organizations & group practices 4

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1437596574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 WESTCHESTER DR STE 203",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627369",
            "telephone_number": "336-702-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KAITLYN",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2016-00809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.