Active NPI
Elizabeth M Watson, PMH-NP
- Psychiatric/Mental Health Nurse Practitioner
- Southern Pines, NC
National Provider Identifier
1699710657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 0050-03028
- Practice address
- 195 W Illinois Ave
Southern Pines, NC 28387-5808 - Phone
- (910) 692-2444
- Fax
- (910) 692-3031
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0050-03028 | NC | Primary |
Addresses
Primary practice location
195 W Illinois Ave
Southern Pines, NC 28387-5808
Mailing address
195 W Illinois Ave
Southern Pines, NC 28387-5808
Phone (910) 692-2444
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078455 | Other | NC | RN LICENSE |
| 142373 | Other | NC | NCMB CERT OF REGISTRATION |
| 6004006 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Certified Nurse Specialist, Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0050-03028 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandhills Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Southern Pines, NC
- NPI 1114998150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409184000000",
"number": "1699710657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 W ILLINOIS AVE",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875808",
"telephone_number": "910-692-2444",
"fax_number": "910-692-3031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 W ILLINOIS AVE",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875808",
"telephone_number": "910-692-2444",
"fax_number": "910-692-3031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "ELIZABETH",
"middle_name": "M",
"credential": "PMH-NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2014-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "0050-03028",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "078455",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCMB CERT OF REGISTRATION",
"identifier": "142373",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6004006",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.