Individual provider Active NPI

Michael Kenneth Watterson, MD, FACR

  • Rheumatology Physician
  • Greenville, NC
National Provider Identifier
1477548584
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2021-01962 Issued in NC
Practice address
1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone
(252) 752-6101
Fax
(252) 752-6600
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2021-01962 NC Primary

Addresses

Primary practice location

1850 W Arlington Blvd
Greenville, NC 27834-5704

Mailing address

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 752-6101

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
I20210728002458 NC Practitioner - RheumatologyPractitioner - Internal Medicine 7719013275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Brody School of Medicine at East Carolina University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians East PAGroup PAC ID 1850284571, 104 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6641

2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians East, PA CurrentSince Sep 1, 2021 Accepting new patients
Physicians East, P.a. Rheumatology CurrentSince Sep 1, 2021 Accepting new patients
Lung Center, PC Past Accepting new patients
Physicians East PA Past Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Arthritis Specialists of Nashville Inc Rheumatology Past Accepting new patients
Columbia Regional Medical Center, LLC Rheumatology Past Accepting new patients

Locations

1850 W Arlington Blvd
Greenville, NC 27834
Phone (252) 413-6641

Interoperability endpoints

  • Direct secure messaging: michaelwatterson@pepa.medalliesdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1477548584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-752-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-752-6101",
            "fax_number": "252-752-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERSON",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD, FACR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "2021-01962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.