Individual provider Active NPI

Dietra Watson

  • Continuing Education/Staff Development Registered Nurse
  • Cincinnati, OH
National Provider Identifier
1699431718
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Continuing Education/Staff Development Registered NurseTaxonomy code 163WC1600X
License
RN314810 Issued in OH
Practice address
3200 Vine St
Cincinnati, OH 45220-2213
Phone
(513) 885-0309
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Continuing Education/Staff Development Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC1600X RN314810 OH Primary

Addresses

Primary practice location

3200 Vine St
Cincinnati, OH 45220-2213

Mailing address

3974 Ashmont Dr
Erlanger, KY 41018-2976
Phone (513) 885-0309

Other practice location 1

4185 Logistics Ave # Areaa
Dayton, OH 45433-5768
Phone (513) 885-0309

Other identifiers 1

IdentifierTypeStateIssuer
36-486108OtherOHCONSULTATION

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

State licenses

LicenseStateTypeSpecialty
RN314810OHMDContinuing Education/Staff Development Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1699431718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3974 ASHMONT DR",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410182976",
            "telephone_number": "513-885-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 VINE ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202213",
            "telephone_number": "513-885-0309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4185 Logistics Ave # Areaa",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454335768",
            "country_code": "US",
            "telephone_number": "513-885-0309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DIETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "OH",
            "license": "RN314810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSULTATION",
            "identifier": "36-486108",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.