Roche Watson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R187378 Issued in MD

Practice address

11637 Terrace Dr
Waldorf, MD 20602-3706

Phone

(301) 870-7287

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• C C Neurology LLC

  • Neurology Physician
  • Waldorf, MD
  • NPI 1750158374

  Family

  Medicare reassignment NPD Authorized official
• Ally Infusion, LLC

  • Infusion Therapy Clinic/Center
  • Brandywine, MD
  • NPI 1881104065
  NPD Authorized official

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1639522659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11637 TERRACE DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023706",
            "telephone_number": "301-870-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11637 TERRACE DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023706",
            "telephone_number": "301-870-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ROCHE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R187378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George H Wathen, MD PA
• Ili Wathen, PA-C
• Christine Watkins
• Nicole Renee Watkins
• Casey Watson
• Kamilah Way, LICSW, LCSW-C
• We Make Kids Smile, LLC
• We Wear Hair LLC
• Jessica L Webb, LCPC
• Brittany Webster

• Family Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.