Individual provider Active NPI

Destiny Michole Watson

  • Homemaker
  • Shaker Heights, OH
National Provider Identifier
1497626501
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Practice address
17720 Scottsdale Blvd
Shaker Heights, OH 44122-6402
Phone
(216) 971-3251
NPI assigned
Sep 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X
Homemaker 376J00000X OH Primary

Addresses

Primary practice location

17720 Scottsdale Blvd
Shaker Heights, OH 44122-6402

Mailing address

17720 Scottsdale Blvd
Shaker Heights, OH 44122-6402
Phone (216) 971-3251

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1497626501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17720 SCOTTSDALE BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441226402",
            "telephone_number": "216-971-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 SCOTTSDALE BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441226402",
            "telephone_number": "216-971-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DESTINY",
        "middle_name": "MICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.