Amanda Marie Watson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12.007329 Issued in CT

Practice address

224 Crown St
Bristol, CT 06010-6125

Phone

(860) 877-3157

NPI assigned

Apr 11, 2018

Last updated

Apr 11, 2018By 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 2

Addresses

Other names 1

• Amanda Marie Ciervo Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Pulmonary Specialties, P.C.Group PAC ID 8628169539, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.watson.1@3118.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/3118/brand/1/csg/1/fhir/r4

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.

• Pulmonary Specialties, P.C.

  • Pulmonary Disease Physician
  • Derby, CT
  • NPI 1437354560
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1720585235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CROWN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106125",
            "telephone_number": "860-877-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CROWN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106125",
            "telephone_number": "860-877-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.007329",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "10.106646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CIERVO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Marie Walton
• Hairong Wang
• Thomas G Ward, M.D.
• Jennifer Lee Wargo, MSW
• Susanne Margaret Wargo, APRN
• Mark D Watson, M.D.
• Savannah Watts
• Tanya Wayne, LMFT
• We-Mpact LLC
• Christine Ann Weaving, MEDATC

• Family Nurse Practitioner in Bristol, CT
• Providers in Bristol, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.