Individual provider Active NPI

Carrie Dawn Watson, D.O.

  • Surgery Physician
  • Rock Hill, SC
National Provider Identifier
1538466040
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
835698 Issued in SC
Practice address
200 Herlong Ave S Ste G
Rock Hill, SC 29732-1182
Phone
(803) 909-6300
Fax
(803) 909-6310
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS14726 FL
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 835698 SC Primary

Addresses

Primary practice location

200 Herlong Ave S Ste G
Rock Hill, SC 29732-1182

Mailing address

2213 Cherry St
Toledo, OH 43608-2603
Phone (678) 386-1753

Other practice location 1

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 909-6300

Other identifiers 1

IdentifierTypeStateIssuer
835699MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20211005002761 SC Practitioner - General SurgeryPractitioner - Other (Physician) 9830484138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

200 Herlong Ave S
Suite G
Rock Hill, SC 29732-1182
Phone (803) 909-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.26 of 100Reported as group
Quality
84.96
Promoting interoperability
100
Improvement activities
40
Cost
72.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83569SCMDForensic Psychiatry Physician
835698SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ocala Health Surgical Group LLC Surgery CurrentSince Aug 7, 2018 Accepting new patients
Piedmont Physician Network LLC Surgery CurrentSince Jun 29, 2021 Accepting new patients
Amisub of South Carolina, Inc. Past Accepting new patients

Locations

1234 SE Magnolia Ext
Unit 1
Ocala, FL 34471
Phone (352) 401-1218

200 Herlong Ave S
Ste G
Rock Hill, SC 29732
Phone (803) 325-1770

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4
  • Direct secure messaging: carrie.watson@hca5.eclinicaldirectplus.com
  • Direct secure messaging: carrie.watson.1@14929.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1538466040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "678-386-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HERLONG AVE S STE G",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321182",
            "telephone_number": "803-909-6300",
            "fax_number": "803-909-6310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Herlong Ave S",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321158",
            "country_code": "US",
            "telephone_number": "803-909-6300",
            "fax_number": "803-909-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CARRIE",
        "middle_name": "DAWN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS14726",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "835698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "835699",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.