Calli Watford, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1770 Issued in SC

Practice address

1175 Cook Rd Ste 145
Orangeburg, SC 29118-8235

Phone

(803) 395-3891

Fax

(803) 536-5220

NPI assigned

Jan 7, 2021

Last updated

Jan 7, 2021By 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

Other names 1

• Calli Deltgen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Clemson University

  • Rural Health Clinic/Center
  • Walhalla, SC
  • NPI 1568345445
  NPD

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1689262362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4497",
            "fax_number": "803-395-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 COOK RD STE 145",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188235",
            "telephone_number": "803-395-3891",
            "fax_number": "803-536-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATFORD",
        "first_name": "CALLI",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "1770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1770",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLI",
            "last_name": "DELTGEN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• George Watson, MED
• Anne Weathers
• Everette Arden Weathers, MD
• Kellie Brabham Weathers
• Stacy W Weaver, P.A.

• Registered Dietitian in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.