Individual provider Active NPI

Byron Greenberry Watson

  • Technician
  • Mesa, AZ
National Provider Identifier
1629390711
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
License
BH2833 Issued in AZ
Practice address
4250 E Florian Ave
Mesa, AZ 85206-2797
Phone
(480) 844-1653
Fax
(480) 539-4947
NPI assigned
Feb 17, 2010
Last updated
Feb 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X BH2833 AZ Primary

Addresses

Primary practice location

4250 E Florian Ave
Mesa, AZ 85206-2797

Mailing address

924 N Country Club Dr
Mesa, AZ 85201-4108
Phone (480) 969-3800

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

State licenses

LicenseStateTypeSpecialty
BH2833AZMDTechnician

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1629390711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014108",
            "telephone_number": "480-969-3800",
            "fax_number": "480-222-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 E FLORIAN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062797",
            "telephone_number": "480-844-1653",
            "fax_number": "480-539-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "BYRON",
        "middle_name": "GREENBERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "AZ",
            "license": "BH2833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.