Individual provider Active NPI

Greggory Earl Watlington Jr., DO

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1649834664
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61280823 Issued in WA
Practice address
510 Boren Ave N
Seattle, WA 98109-5501
Phone
(206) 320-5200
Fax
(206) 320-5202
NPI assigned
Apr 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61280823 WA Primary

Addresses

Primary practice location

510 Boren Ave N
Seattle, WA 98109-5501

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2213928MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20220725001634 WA Practitioner - Family Practice 3375879992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

510 Boren Ave N
Seattle, WA 98109-5501
Phone (206) 320-5200

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Swedish Health Services Family Medicine Current Accepting new patients
Swedish Health Services CurrentSince Jul 11, 2022 Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

510 Boren Ave N
Seattle, WA 98109
Phone (206) 320-5200

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 800
Seattle, WA 98104
Phone (206) 533-2944

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1649834664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BOREN AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095501",
            "telephone_number": "206-320-5200",
            "fax_number": "206-320-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATLINGTON",
        "first_name": "GREGGORY",
        "middle_name": "EARL",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61280823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2213928",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.