Individual provider Active NPI

Kristopher Leigh Watson, FNP

  • Family Nurse Practitioner
  • Delhi, LA
National Provider Identifier
1700387974
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09797 Issued in LA
Practice address
501 Broadway St
Delhi, LA 71232-3001
Phone
(318) 878-6650
Fax
(318) 878-6321
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP09797 LA Primary

Addresses

Primary practice location

501 Broadway St
Delhi, LA 71232-3001

Mailing address

PO Box 17832
Belfast, ME 04915-4073
Phone (318) 878-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719000580 LA Order and Referring Only - Nurse Practitioner 5496001810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP09797LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District No 1-a of the Parish of Richland State of la Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristopher.watson.2@13199.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1700387974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17832",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154073",
            "telephone_number": "318-878-6650",
            "fax_number": "318-878-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BROADWAY ST",
            "city": "DELHI",
            "state": "LA",
            "postal_code": "712323001",
            "telephone_number": "318-878-6650",
            "fax_number": "318-878-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KRISTOPHER",
        "middle_name": "LEIGH",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delhi, LA

Sources for this page

Verify at the official NPI Registry.