Individual provider Active NPI

Melissa Watson, FNP-C

  • Family Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1619408754
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132931 Issued in TX
Practice address
3350 Executive Dr
Suite 108
San Angelo, TX 76904
Phone
(325) 245-4541
NPI assigned
Mar 21, 2017
Last updated
May 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132931 TX Primary

Addresses

Primary practice location

3350 Executive Dr
Suite 108
San Angelo, TX 76904

Mailing address

3350 Executive Dr Ste 108
San Angelo, TX 76904-6878
Phone (325) 245-4541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20170531000629 TX Practitioner - Nurse Practitioner 1153698824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

2142 Sunset Dr
San Angelo, TX 76904-6829
Phone (325) 747-1511

220 E Harris Ave
San Angelo, TX 76903-5906
Phone (325) 747-1511

3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7500

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-1511

4235 Southwest Blvd
San Angelo, TX 76904-5635
Phone (325) 747-1511

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Current Accepting new patients
Shannon Clinic CurrentSince Jul 1, 2020 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince May 1, 2017 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince May 1, 2017 Accepting new patients

Locations

3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361

3350 Executive Dr
Ste 108
San Angelo, TX 76904
Phone (325) 245-4541

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

102 N Magdalen St
San Angelo, TX 76903
Phone (325) 481-2025

Interoperability endpoints

  • Direct secure messaging: mwatson38906@shannonhealth.direct-ci.com

Organizations & group practices 4

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 4

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1619408754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 EXECUTIVE DR STE 108",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046878",
            "telephone_number": "325-245-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 EXECUTIVE DR",
            "address_2": "SUITE 108",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-245-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MELISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.