Active NPI
Charles Hunter Watts, M.D.
- Pediatric Adolescent Medicine Physician
- Marrero, LA
National Provider Identifier
1730180183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 013740
- Practice address
- 4225 Lapalco Blvd
Marrero, LA 70073-2400 - Phone
- (504) 391-7337
- Fax
- (504) 398-7213
- NPI assigned
- Aug 9, 2005
- Last updated
- Nov 7, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 013740 | LA | Primary |
Addresses
Primary practice location
4225 Lapalco Blvd
Marrero, LA 70073-2400
Mailing address
PO Box 2400
Marrero, LA 70073-2400
Phone (504) 391-7337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1300721 | Medicaid | LA |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013740 | LA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westside Clinics Anc | Adolescent Medicine | 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, 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": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1730180183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2400",
"city": "MARRERO",
"state": "LA",
"postal_code": "700732400",
"telephone_number": "504-391-7337",
"fax_number": "504-398-7213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 LAPALCO BLVD",
"city": "MARRERO",
"state": "LA",
"postal_code": "700732400",
"telephone_number": "504-391-7337",
"fax_number": "504-398-7213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "CHARLES",
"middle_name": "HUNTER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "LA",
"license": "013740",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1300721",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marrero, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.