Active NPI
Ursula Alice Watson, MD
- Emergency Medicine Physician
- Norcross, GA
National Provider Identifier
1528113313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- GA 026675
- Practice address
- 6920 Jimmy Carter Blvd Ste 100
Norcross, GA 30071-1246 - Phone
- (770) 449-0990
- Fax
- (770) 448-8818
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | GA 026675 | GA | Primary |
Addresses
Primary practice location
6920 Jimmy Carter Blvd Ste 100
Norcross, GA 30071-1246
Mailing address
625 Kings Grant Walk
Roswell, GA 30075-5528
Phone (770) 518-1354
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 581762046 | Other | GA | GA CLINIC TAX ID |
| 000425565G | Other | GA | GA URGENT CARE MCAID ID |
| 511I930104 | Other | GA | GA URGENT CARE MCARE PIN |
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 |
|---|---|---|---|
| GA 026675 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Medical LLC | 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.
-
- Emergency Care Clinic/Center
- Dunwoody, GA
- NPI 1417011099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273795200000",
"number": "1528113313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 KINGS GRANT WALK",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300755528",
"telephone_number": "770-518-1354",
"fax_number": "770-557-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6920 JIMMY CARTER BLVD STE 100",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300711246",
"telephone_number": "770-449-0990",
"fax_number": "770-448-8818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "URSULA",
"middle_name": "ALICE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2010-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "GA 026675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA CLINIC TAX ID",
"identifier": "581762046",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA URGENT CARE MCAID ID",
"identifier": "000425565G",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA URGENT CARE MCARE PIN",
"identifier": "511I930104",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.