Terri Susanne Jones Watkins Odpsc

Primary specialty

OptometristTaxonomy code 152W00000X

License

1235DT Issued in KY

Legal business name

TERRI SUSANNE JONES WATKINS ODPSC

Doing business as

Watkins Vision Center

Practice address

24 Caden Way, Suite 2
Russell Springs, KY 42642

Phone

(270) 866-3177

Fax

(270) 866-3155

NPI assigned

Apr 16, 2014

Last updated

Jul 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terri Susanne Jones Watkins, OD

Title

Owner/President

Phone

(270) 866-3177

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Watkins Vision Center Doing business as

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1619397775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 582",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426420582",
            "telephone_number": "270-866-3177",
            "fax_number": "270-866-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CADEN WAY, SUITE 2",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "42642",
            "telephone_number": "270-866-3177",
            "fax_number": "270-866-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRI SUSANNE JONES WATKINS ODPSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "JONES WATKINS",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "SUSANNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "270-866-3177",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1235DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77012359",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watkins Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Russell Springs, KY
• Providers in Russell Springs, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.