Individual provider Active NPI

Joe Luke Watson, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1629210109
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
017859-1 Issued in NY
Practice address
175 Remsen Street
4TH Floor
Brooklyn, NY 11201
Phone
(718) 306-1354
NPI assigned
Mar 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 017859-1 NY Primary

Addresses

Primary practice location

175 Remsen Street
4TH Floor
Brooklyn, NY 11201

Mailing address

114 E 13TH St
PHC
New York, NY 10003-5329
Phone (646) 284-2175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
017859-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. Past Accepting new patients
Premier Healthcare, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1629210109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E 13TH ST",
            "address_2": "PHC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035329",
            "telephone_number": "646-284-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 REMSEN STREET",
            "address_2": "4TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-306-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JOE",
        "middle_name": "LUKE",
        "name_prefix": "Mr.",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "017859-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.