Micah John Watts, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT005056 Issued in PA

Practice address

97 Bochicchio Blvd
Covington TWP, PA 18444-6695

Phone

(570) 428-4287

NPI assigned

Dec 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1679233365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 HUNTERS WOODS DR",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183017603",
            "telephone_number": "570-428-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 BOCHICCHIO BLVD",
            "city": "COVINGTON TWP",
            "state": "PA",
            "postal_code": "184446695",
            "telephone_number": "570-428-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "MICAH",
        "middle_name": "JOHN",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT005056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "micah.watts@lvhn.org",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "Lehigh Valley Hospital - Coordinated Health Allentown",
            "address_1": "3435 Winchester Rd",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181042268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Athletic Trainer in Covington TWP, PA
• Providers in Covington TWP, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.