Active NPI
Mattie Watson
- Behavior Analyst
- Chattanooga, TN
National Provider Identifier
1629473962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1V609C
- Practice address
- 1119 Gillespie Rd
Chattanooga, TN 37411-1516 - Phone
- (423) 355-5200
- Fax
- (423) 355-5201
- NPI assigned
- Oct 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1V609C | TN | Primary |
Addresses
Primary practice location
1119 Gillespie Rd
Chattanooga, TN 37411-1516
Mailing address
1119 Gillespie Rd
Chattanooga, TN 37411-1516
Phone (423) 355-5200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1V609C | TN | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414540800000",
"number": "1629473962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1119 GILLESPIE RD",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374111516",
"telephone_number": "423-355-5200",
"fax_number": "423-355-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 GILLESPIE RD",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374111516",
"telephone_number": "423-355-5200",
"fax_number": "423-355-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "MATTIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-29",
"last_updated": "2014-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "1V609C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.