NPIMap

Individual provider Active NPI

Jerry Lynn Watson, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
National Provider Identifier
1497771216
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9400388 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-7000
Fax
(919) 350-8959
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101271393 VA
Diagnostic Radiology Physician 2085R0202X 9400388 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

5220 Greens Dairy Rd
Raleigh, NC 27616-4612
Phone (540) 493-4581

Other practice location 1

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 200-5047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA, SC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040217000541 NC Practitioner - Diagnostic Radiology 4688569858 Reassigns benefits to 5 organizations
I20210304002285 VA Practitioner - Diagnostic Radiology 4688569858 Reassigns benefits to 1 organization
I20210304002421 SC Practitioner - Diagnostic Radiology 4688569858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Radiology Associates IncGroup PAC ID 6800874611, 58 clinicians
Raleigh Radiology Wakemed Imaging, LLCGroup PAC ID 8325453459, 57 clinicians
Raleigh Radiology LLCGroup PAC ID 6305739707, 61 clinicians
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians
Wake Pet Services LLCGroup PAC ID 4789084567, 6 clinicians

Practice addresses (Care Compare)

10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-7000

11640 Northpark Dr
Suite 110
Wake Forest, NC 27587-5741
Phone (919) 781-1437

120 Healthplex Way
Apex, NC 27502-8403
Phone (919) 350-7000

150 Pkwy Office CT
Suite 100
Cary, NC 27518-0002
Phone (919) 781-1437

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 350-7000

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

1905 Park Dr
Raleigh, NC 27605-1614
Phone (434) 200-5047

210 Ashville Ave
Suite 120
Cary, NC 27518-6676
Phone (919) 350-6513

23 Sunnybrook Rd
Raleigh, NC 27610-1855
Phone (919) 350-7000

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7000

400 US 70 Hwy E
Garner, NC 27529-4049
Phone (919) 350-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.55 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9400388NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Jun 15, 2023 Accepting new patients
Raleigh Radiology Wakemed Imaging, LLC Diagnostic Radiology CurrentSince Feb 19, 2021 Accepting new patients
Wake Pet Services LLC Diagnostic Radiology CurrentSince Mar 9, 2021 Accepting new patients
Raleigh Radiology, LLC Diagnostic Radiology CurrentSince Jul 1, 1999 Accepting new patients

Locations

1585 Kapiolani Blvd
Ste 920
Honolulu, HI 96814
Phone (972) 493-3846

150 Parkway Office Ct
Ste 100
Cary, NC 27518

210 Ashville Ave
Ste 120
Cary, NC 27518
Phone (919) 350-6513

3700 Computer Dr
Ste 240
Raleigh, NC 27609
Phone (919) 787-8815

3200 Blue Ridge Rd
Ste 100
Raleigh, NC 27612
Phone (919) 256-3576

5220 Greens Dairy Rd
Raleigh, NC 27616
Phone (540) 493-4581

8851 Ellstree Ln
Ste 100
Raleigh, NC 27617
Phone (919) 532-3425

1121 Situs Ct
Ste 170
Raleigh, NC 27606
Phone (919) 834-2767

3900 Barrett Dr
Ste 100
Raleigh, NC 27609
Phone (919) 787-8815

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

11640 Northpark Dr
Ste 110
Wake Forest, NC 27587

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

Interoperability endpoints

  • Direct secure messaging: jerry.watson@direct.raleighrad.nchie.net

Organizations & group practices 5

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1497771216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 GREENS DAIRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276164612",
            "telephone_number": "540-493-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-7000",
            "fax_number": "919-350-8959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Tate Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245011109",
            "country_code": "US",
            "telephone_number": "434-200-5047",
            "fax_number": "434-200-6490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JERRY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101271393",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "9400388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.