Individual provider Active NPI

Tracy Colleen Watkins, ARNP

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1528595030
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9355896 Issued in FL
Practice address
13782 Plantation Rd Ste 201
Fort Myers, FL 33912-4462
Phone
(239) 343-1290
Fax
(239) 343-4008
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9355896 FL Primary

Addresses

Primary practice location

13782 Plantation Rd Ste 201
Fort Myers, FL 33912-4462

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-1290

Other practice location 1

1140 Pratt Blvd
LaBelle, FL 33935-4405
Phone (863) 674-4041

Other practice location 2

540 The Rialto
Venice, FL 34285-2900
Phone (941) 485-7711

Other identifiers 1

IdentifierTypeStateIssuer
023617700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twatkins259025@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831000461 FL Practitioner - Nurse Practitioner 8123391810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9355896FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Feb 22, 2021 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Feb 22, 2021 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

1100 S Olympia St
Clewiston, FL 33440
Phone (561) 996-9573

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

12600 Creekside Ln
Ste 2
Fort Myers, FL 33919
Phone (239) 343-9235

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

13782 Plantation Rd
Ste 201
Fort Myers, FL 33912
Phone (239) 343-1100

1140 Pratt Blvd
Labelle, FL 33935
Phone (863) 674-4041

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: twatkins259025@direct.leememorial.org

Organizations & group practices 4

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1528595030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-1290",
            "fax_number": "239-343-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13782 PLANTATION RD STE 201",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124462",
            "telephone_number": "239-343-1290",
            "fax_number": "239-343-4008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1140 Pratt Blvd",
            "address_purpose": "LOCATION",
            "city": "LaBelle",
            "state": "FL",
            "postal_code": "339354405",
            "country_code": "US",
            "telephone_number": "863-674-4041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 The Rialto",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342852900",
            "country_code": "US",
            "telephone_number": "941-485-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "TRACY",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9355896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023617700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twatkins259025@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.