Individual provider Active NPI

Polly Jansen Watson, MD

  • Obstetrics & Gynecology Physician
  • Raleigh, NC
National Provider Identifier
1730111238
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
200501059 Issued in NC
Practice address
211 E Six Forks Rd Ste 120
Raleigh, NC 27609-7755
Phone
(919) 364-3430
Fax
(833) 631-6938
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X BW8739306 NC
Obstetrics & Gynecology Physician 207V00000X 200501059 NC Primary

Addresses

Primary practice location

211 E Six Forks Rd Ste 120
Raleigh, NC 27609-7755

Mailing address

211 E Six Forks Rd Ste 120
Raleigh, NC 27609-7755
Phone (919) 364-3430

Other identifiers 1

IdentifierTypeStateIssuer
5903491MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2019 through Apr 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200501059NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hormone Wellness MD CurrentSince Apr 15, 2008 Accepting new patients
Unc Physicians Network LLC Obstetrics & Gynecology Past Accepting new patients

Locations

211 E Six Forks Rd
Ste 120
Raleigh, NC 27609
Phone (919) 364-3430

4414 Lake Boone Trl
Ste 407
Raleigh, NC 27607
Phone (919) 615-2043

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1730111238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097755",
            "telephone_number": "919-364-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097755",
            "telephone_number": "919-364-3430",
            "fax_number": "833-631-6938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "POLLY",
        "middle_name": "JANSEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "BW8739306",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200501059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903491",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.