Individual provider Active NPI

Terri-Ann Wattsman, MD

  • Surgery Physician
  • Roanoke, VA
National Provider Identifier
1598737843
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101053004 Issued in VA
Practice address
4348 Electric Rd
Roanoke, VA 24018-0720
Phone
(540) 769-0976
Fax
(540) 857-5383
NPI assigned
Feb 2, 2006
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101053004 VA Primary
Surgery Physician 208600000X 0101-053004 VA
Surgery Physician 208600000X 01068504A IN
Pediatric Surgery Physician 2086S0120X 01068504A IN

Addresses

Primary practice location

4348 Electric Rd
Roanoke, VA 24018-0720

Mailing address

102 Highland Ave SE Ste 404
Roanoke, VA 24013-2232
Phone (540) 985-9812

Other identifiers 2

IdentifierTypeStateIssuer
7309929MedicaidVA
200993180MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twattsman21608@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20051027000463 VA Practitioner - General Surgery 5890712004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of Ny Upstate Medical University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

102 Highland Ave SE
Suite 404
Roanoke, VA 24013-2232
Phone (540) 985-9812

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-053004VAMDSurgery Physician
0101053004VAMDSurgery Physician
01068504AINMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jan 1, 2017 Accepting new patients
Carilion Healthcare Corporation CurrentSince May 12, 2017 Accepting new patients
Carilion Healthcare Corporation CurrentSince May 12, 2017 Accepting new patients
Carilion Medical Center CurrentSince Jan 1, 2017 Accepting new patients
Carilion Medical Center Past Accepting new patients
Community Hospitals of Indiana Inc Surgery Past Accepting new patients

Locations

102 Highland Ave SE
Ste 404
Roanoke, VA 24013
Phone (540) 985-9812

1722 Belleview Ave SE
Roanoke, VA 24014
Phone 54098117000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: twattsman21608@direct.carilionclinic.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1598737843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HIGHLAND AVE SE STE 404",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132232",
            "telephone_number": "540-985-9812",
            "fax_number": "540-985-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180720",
            "telephone_number": "540-769-0976",
            "fax_number": "540-857-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTSMAN",
        "first_name": "TERRI-ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101053004",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101-053004",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01068504A",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IN",
            "license": "01068504A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7309929",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200993180",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twattsman21608@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "twattsman21608@direct.carilionclinic.org",
            "address_1": "102 Highland Ave SE Ste 404",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240132232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.