Organization Active NPI

Stephen D. Watson, M.D., PHD., Inc.

  • Specialist
  • Springfield, OH
National Provider Identifier
1528089786
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35063329W Issued in OH
Legal business name
STEPHEN D. WATSON, M.D., PHD., INC.
Practice address
2816 W 1St St
Springfield, OH 45504-4264
Phone
(937) 323-3900
Fax
(937) 398-0329
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Julie L. Ledbetter, CMAA, CPC
Title
Billing / Office Manager
Phone
(937) 323-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35063329W OH Primary

Addresses

Primary practice location

2816 W 1St St
Springfield, OH 45504-4264

Mailing address

2816 W 1St St
Springfield, OH 45504-4264
Phone (937) 323-3900

Other identifiers 1

IdentifierTypeStateIssuer
2106385MedicaidOH

Other names 1

  • Innovative Pain Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

1240 E Main St
Springfield, OH 45503
Phone (866) 403-3870

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528089786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 W 1ST ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455044264",
            "telephone_number": "937-323-3900",
            "fax_number": "937-398-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 W 1ST ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455044264",
            "telephone_number": "937-323-3900",
            "fax_number": "937-398-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN D. WATSON, M.D., PHD., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "BILLING / OFFICE MANAGER",
        "authorized_official_telephone_number": "937-323-3900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMAA, CPC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35063329W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2106385",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.