Organization Active NPI

Jeffrey W. Watson, D.P.M.

  • Durable Medical Equipment & Medical Supplies
  • Emporia, KS
National Provider Identifier
1679751622
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
12-00179 Issued in KS
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

Updated by the provider on Feb 1, 2008

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20100930092760 KS DME Supplier - Physician - Podiatry 7113044454 Practice locations: Emporia, KS

National Provider Directory

National Provider Directory

Locations

2534 W 15th Ave
Emporia, KS 66801
Phone (620) 343-6011

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.