NPIMap

Individual provider Active NPI

Derek Scott Watson, MD

  • Surgery Physician
  • Simpsonville, SC
National Provider Identifier
1699883454
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
19376 Issued in SC
Practice address
727 SE Main St
Suite 130
Simpsonville, SC 29681-3247
Phone
(864) 454-6560
Fax
(864) 454-6565
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 19376 SC
Surgery Physician 208600000X 19376 SC Primary

Addresses

Primary practice location

727 SE Main St
Suite 130
Simpsonville, SC 29681-3247

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 3

IdentifierTypeStateIssuer
576007863173OtherSCBCBS
P00392345OtherSCRR MEDICARE
T33951MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwatson5645@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070108000353 SC Practitioner - General Surgery 4385644814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Vanderbilt University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

727 Semain St
Suite 130
Simpsonville, SC 29681-3266
Phone (864) 454-6560

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy41
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux11
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19376SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System CurrentSince Aug 15, 2014 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

309 E 1st Ave
Easley, SC 29640
Phone (864) 850-2663

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

13 Edgewood Dr
Greenville, SC 29605
Phone (864) 271-6060

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Ste A14
Greenville, SC 29615
Phone (864) 454-2224

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

7 Independence Pt
Ste 100
Greenville, SC 29615
Phone (864) 797-6106

1210 W Faris Rd
Greenville, SC 29605
Phone (864) 295-4410

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

727 SE Main St
Ste 130
Simpsonville, SC 29681
Phone (864) 454-6560

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

733 SE Main St
Simpsonville, SC 29681
Phone (864) 233-4325

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: dwatson5645@direct.ghs.myhfn.org

Organizations & group practices 4

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.

Hospital & facility affiliations 43

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1699883454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE MAIN ST",
            "address_2": "SUITE 130",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813247",
            "telephone_number": "864-454-6560",
            "fax_number": "864-454-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DEREK",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "SC",
            "license": "19376",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "19376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "576007863173",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00392345",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T33951",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwatson5645@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dwatson5645@direct.ghs.myhfn.org",
            "address_1": "727 SE Main St",
            "address_2": "Suite 130",
            "city": "Simpsonville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296813247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.