Nikki D Watson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209019517 Issued in IL

Practice address

701 N 1St St
Springfield, IL 62781-0001

Phone

(217) 788-3000

NPI assigned

Jun 13, 2019

Last updated

Jun 13, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Southern Illinois University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iredell Memorial Hospital IncorporatedGroup PAC ID 0648175927, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Iredell Memorial Hospital, Incorporated

  dba IMH Professional CRNA

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1548230204
  Medicare reassignment Care Compare group NPD
• Lake Norman Anesthesia Associates

  • Specialist
  • Mooresville, NC
  • NPI 1386753457
  Medicare reassignment NPD
• Iredell Physician Network LLC

  • General Practice Physician
  • Statesville, NC
  • NPI 1811381593
  Medicare reassignment
• Iredell Memorial Hospital Incorporated

  dba Iredell Davis Behavioral Health Hospital

  • Psychiatric Hospital
  • Statesville, NC
  • NPI 1417783705
  NPD
• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  NPD
• Iredell Physician Network LLC

  dba Iredell Ear, Nose and Throat

  • Otolaryngology Physician
  • Statesville, NC
  • NPI 1447063920
  NPD
• Iredell Physician Network, LLC

  dba Iredell Surgery at Mooresville ASC

  • Ambulatory Surgical Clinic/Center
  • Mooresville, NC
  • NPI 1518549393
  NPD

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

• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1669031530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "217-588-2624",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "NIKKI",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209019517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041-421740",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Watson
• John O Watson, MD
• John Ward Watson, M.D.
• Laci Watson, NP
• Melissa Kay Watson, CSFA
• Ryan Ridgway Watson, MD
• Watt Bros Pharmacy Inc (Watt Brothers Pharmacy)
• Cody M Watts, BEHAVIOR ANALYST
• Kendra K Watts, AU.D.
• Nicole Lynn Watts

• Certified Registered Nurse Anesthetist in Springfield, IL
• Providers in Springfield, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.