Active NPI
Charles T Watson, MD
- Otolaryngology Physician
- Ashland, KY
National Provider Identifier
1487759536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 17669
- Practice address
- 2301 Lexington Ave
Ashland, KY 41101-2873 - Phone
- (606) 324-1188
- Fax
- (606) 325-3843
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 17669 | KY | Primary |
Addresses
Primary practice location
2301 Lexington Ave
Ashland, KY 41101-2873
Mailing address
PO Box 1717
Ashland, KY 41105-1717
Phone (606) 324-1188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64176696 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17669 | KY | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ashland Ear, Nose & Throat Clinic, PSC | Otolaryngology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- Ashland, KY
- NPI 1477658524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290038400000",
"number": "1487759536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1717",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411051717",
"telephone_number": "606-324-1188",
"fax_number": "606-325-3843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 LEXINGTON AVE",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411012873",
"telephone_number": "606-324-1188",
"fax_number": "606-325-3843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "CHARLES",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2010-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "KY",
"license": "17669",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64176696",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.