Active NPI
Jeffrey W. Watson, D.P.M.
- Durable Medical Equipment & Medical Supplies
- Emporia, KS
National Provider Identifier
1679751622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 12-00179
- Legal business name
- JEFFREY W. WATSON, D.P.M.
- Practice address
- 2534 W 15TH Ave
Emporia, KS 66801-6102 - Phone
- (620) 343-6011
- Fax
- (620) 343-6353
- NPI assigned
- Feb 1, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susie K Watson
- Title
- Office Manager
- Phone
- (620) 343-6011
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 12-00179 | KS | Primary |
Addresses
Primary practice location
2534 W 15TH Ave
Emporia, KS 66801-6102
Mailing address
2534 W 15TH Ave
Emporia, KS 66801-6102
Phone (620) 343-6011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930092760 | KS | DME Supplier - Physician - Podiatry | 7113044454 | Practice locations: Emporia, KS |
National Provider Directory
National Provider DirectoryLocations
2534 W 15th Ave
Emporia, KS 66801
Phone (620) 343-6011
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/gVhfMvu-XwQRgQosgHcm4vmauyjhpt-k/
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Emporia, KS
- NPI 1821108036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1201824000000",
"number": "1679751622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2534 W 15TH AVE",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668016102",
"telephone_number": "620-343-6011",
"fax_number": "620-343-6353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2534 W 15TH AVE",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668016102",
"telephone_number": "620-343-6011",
"fax_number": "620-343-6353"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEFFREY W. WATSON, D.P.M.",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-01",
"last_updated": "2008-02-01",
"status": "A",
"authorized_official_last_name": "WATSON",
"authorized_official_first_name": "SUSIE",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "620-343-6011"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "KS",
"license": "12-00179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Emporia, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.