Dia Watson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA540 Issued in AR

Practice address

2010 Active Way
Bryant, AR 72022-9267

Phone

(501) 315-0984

Fax

(501) 847-1405

NPI assigned

Feb 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Gastro Clinics of Arkansas, PLLC

  • Specialist
  • North Little Rock, AR
  • NPI 1972944064
  Medicare reassignment
• Saline Orthopedic Group P a

  • Orthopaedic Surgery Physician
  • Benton, AR
  • NPI 1093825002
  Medicare reassignment
• Arkansas Gastroenterology

  • Specialist
  • North Little Rock, AR
  • NPI 1952358657
  NPD (past)
• Saline Orthopedic Group P a

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Benton, AR
  • NPI 1588348783
  NPD (past)

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1609290220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ACTIVE WAY",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720229267",
            "telephone_number": "501-315-0984",
            "fax_number": "501-847-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ACTIVE WAY",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720229267",
            "telephone_number": "501-315-0984",
            "fax_number": "501-847-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 N University Ave",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722053108",
            "country_code": "US",
            "telephone_number": "501-664-6980",
            "fax_number": "501-664-4738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE MEDICAL LICENSE",
            "identifier": "PA540",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Walker
• Walker'S Group L.L.C.
• Walmart Inc.
• Kaitlyn Walters
• Kendaydria Watkins
• Cynthia J. Webb, LPC-S
• Wellness Center of Arkansas LLC
• Renee Wells
• Stephanie West
• Tiffany Weston

• Physician Assistant in Bryant, AR
• Providers in Bryant, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.