Individual provider Active NPI

Wayne L Watkins, M.D.

  • Surgery Physician
  • Alexandria, LA
National Provider Identifier
1538168554
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
04309R Issued in LA
Practice address
3311 Prescott Rd
Suite 201
Alexandria, LA 71301-3900
Phone
(318) 442-6767
Fax
(318) 441-1359
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 04309R LA Primary

Addresses

Primary practice location

3311 Prescott Rd
Suite 201
Alexandria, LA 71301-3900

Mailing address

3311 Prescott Rd
Suite 201
Alexandria, LA 71301-3900
Phone (318) 442-6767

Other identifiers 5

IdentifierTypeStateIssuer
020054511OtherRAILROAD MEDICARE
331030935A003OtherTRICARE
1306959MedicaidLA
331030935WAOtherOCHSNER
5L273CD82OtherMEDICARE PART B OF LA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000657 LA Practitioner - General Surgery 3971519125 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04309RLAMDSurgery Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1538168554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD",
            "address_2": "SUITE 201",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013900",
            "telephone_number": "318-442-6767",
            "fax_number": "318-441-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD",
            "address_2": "SUITE 201",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013900",
            "telephone_number": "318-442-6767",
            "fax_number": "318-441-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "WAYNE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "04309R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020054511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "331030935A003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306959",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCHSNER",
            "identifier": "331030935WA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B OF LA",
            "identifier": "5L273CD82",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.