Jefferson Tyler Watson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

63139 Issued in TN

Practice address

660 S Mount Juliet Rd Ste 230
Mt Juliet, TN 37122-6496

Phone

(615) 874-9667

Fax

(615) 871-9682

NPI assigned

Jun 7, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

General Surgery

Education

Medical University of South Carolina College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Cooper Physician Group LLC 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089
• Trident Medical Center Hospital, Charleston, SC, CCN 420079

Merit-based Incentive Payment System (MIPS)

Final score

85.69 of 100Reported as group

Quality

70.45

Promoting interoperability

100

Improvement activities

40

Cost

73.38

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• East Cooper Physician Group LLC

  • Internal Medicine Physician
  • Daniel Island, SC
  • NPI 1861253981

  SC

  Medicare reassignment Care Compare group NPD
• East Cooper Physician Group LLC

  • Body Imaging Physician
  • Mt Pleasant, SC
  • NPI 1699641571
  Care Compare group NPD
• East Cooper Physician Group LLC

  • Internal Medicine Physician
  • Daniel Island, SC
  • NPI 1255192308
  NPD
• East Cooper Physician Group LLC

  • Internal Medicine Physician
  • Summerville, SC
  • NPI 1982475604
  NPD (past)

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

• East Cooper Medical Center LLC

  • General Acute Care Hospital
  • Mount Pleasant, SC
  • NPI 1841069044

  Hospital

  Care Compare affiliation
• Trident Medical Center, LLC

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1447511290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 42ND AVE N STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372093658",
            "telephone_number": "153-297-8876",
            "fax_number": "615-340-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S MOUNT JULIET RD STE 230",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371226496",
            "telephone_number": "615-874-9667",
            "fax_number": "615-871-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JEFFERSON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "304165",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "63139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Alan Wall, PT, DPT
• Haley Wallace
• Glennae Camille Walton
• Karmen Elizabeth Wanchisn
• Amanda Ward, DMD
• Rachel Katherine Watson, MSN-C,
• Timika Evon Webb
• Jade Christian Weber
• Katelyn Elizabeth Roxanne Weber, FNP
• Sara Wei, DDS

• All providers in Mt Juliet, TN
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.