Thomas M Watanabe

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

44158 Issued in TN

Practice address

651 Dunlop LN
Clarksville, TN 37040-5015

Phone

(931) 502-1370

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Emergency Medicine

Education

Rush Medical College of Rush University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Irv Edwards MD PCGroup PAC ID 2365926698, 33 clinicians

Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henderson Hospital Hospital, Henderson, NV, CCN 290057
• Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1184795874
  Medicare reassignment Care Compare group NPD
• Irv Edwards MD PC

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1013884352
  Medicare reassignment Care Compare group
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919
  NPD
• Midway Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1447397526
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henderson Hospital

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1003281452
  Care Compare affiliation
• Henderson Hospital

  • Emergency Care Clinic/Center
  • Henderson, NV
  • NPI 1285490292

  Hospital

  Care Compare affiliation
• Henderson Hospital

  • Emergency Care Clinic/Center
  • Henderson, NV
  • NPI 1376198028

  Hospital

  Care Compare affiliation
• Valley Hospital Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1396436630

  Hospital

  Care Compare affiliation
• Valley Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1417947490
  Care Compare affiliation
• Valley Hospital Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1598479602

  Hospital

  Care Compare affiliation
• Valley Hospital Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1770150914

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1629284872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 21ST AVE S STE 201",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124354",
            "telephone_number": "615-269-0652",
            "fax_number": "615-269-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405015",
            "telephone_number": "931-502-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "THOMAS",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036116691",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "44158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Washington
• Mina Washington, MSW
• Shante Washington, FNP
• Julia Ann Waskiewicz, LMFT
• Candyce Waszmer, MSW
• Chantae Laurel Watford, RN
• Hollister Watkins-Boyd
• Amber Watkins
• Laura Rogers Watkins, M. ED., BCBA
• Crystal K Watson

• Emergency Medicine Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.