Active NPI
Justus Watters, PHARM.D
- Pharmacist
- Scottsbluff, NE
National Provider Identifier
1669474482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12098
- Practice address
- 4021 Avenue B
Pharmacy Department
Scottsbluff, NE 69361-4602 - Phone
- (308) 630-1262
- NPI assigned
- Aug 11, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12098 | NE | Primary |
| Pharmacist | 183500000X | 3021 | WY |
Addresses
Primary practice location
4021 Avenue B
Pharmacy Department
Scottsbluff, NE 69361-4602
Mailing address
2932 19TH Ave
Scottsbluff, NE 69361-1845
Phone (308) 631-1528
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12098 | NE | MD | Professional Counselor |
| 3021 | WY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1669474482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2932 19TH AVE",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693611845",
"telephone_number": "308-631-1528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4021 AVENUE B",
"address_2": "PHARMACY DEPARTMENT",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614602",
"telephone_number": "308-630-1262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTERS",
"first_name": "JUSTUS",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "12098",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3021",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.