Jerome Bradfield Watson, GNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP108606 Issued in TX

Practice address

7209 Goldfinch Rd
Texarkana, TX 75501-0227

Phone

(903) 334-8132

Fax

(903) 334-8146

NPI assigned

May 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in AR, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brittain and Associates IncGroup PAC ID 2668455221, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Jerome Watson LLC

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1477793479

  AR

  Medicare reassignment NPD Authorized official
• Brittain & Associates Inc

  dba Carousel Clinical Services

  • Clinical Psychologist
  • Ore City, TX
  • NPI 1285650457
  Medicare reassignment Care Compare group
• Vohra Post Acute Care Physicians of Texas, PLLC

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1821424789
  Medicare reassignment NPD

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1538162045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 GOLDFINCH RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755010227",
            "telephone_number": "903-334-8132",
            "fax_number": "903-334-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7209 GOLDFINCH RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755010227",
            "telephone_number": "903-334-8132",
            "fax_number": "903-334-8146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17218 Preston Rd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752524018",
            "country_code": "US",
            "telephone_number": "877-866-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JEROME",
        "middle_name": "BRADFIELD",
        "name_prefix": "Mr.",
        "credential": "GNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "605190",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP108606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082540A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500004259",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX RAILROAD MEDICARE",
            "identifier": "P00267929",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029325001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - LEGACY NUMBER",
            "identifier": "5U081",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145430758",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160262762",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29325004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029325002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500004259",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - LEGACY NUMBER",
            "identifier": "8D9579",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey Suzanne Ward, CRNA
• Lesa Donise Warren, LMSW-ACP, LCSW
• Emily Washington, LPC
• Bobbie Jean Watson, LPC
• Ian Watson, NP
• Karla Watson, LOT/R
• Randi Marie Watson, M.S., CCC/SLP
• Thomas R Watson, M.D.
• Alexandra Rose Webb
• David R Weber, M.D.

• Nurse Practitioner in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.