Philip Dean Watson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1463 Issued in OK

Practice address

1203 E Ross Byp
Suite a
Tahlequah, OK 74464-4133

Phone

(918) 453-1234

Fax

(918) 453-9107

NPI assigned

Feb 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adair County Health Center IncGroup PAC ID 9638065907, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Stilwell, OK, CCN 370785
• Memorial Hospital Hospital, Stilwell, OK, CCN 370178
• Northeastern Health System Hospital, Tahlequah, OK, CCN 370089

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Adair County Health Center, Inc.

  • Medical Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1972780765
  Medicare reassignment Care Compare group NPD
• Adair County Health Center, Inc.

  • Rural Acute Care Hospital
  • Stilwell, OK
  • NPI 1790753358
  NPD
• Adair County Health Center,Inc.

  • Family Medicine Physician
  • Stilwell, OK
  • NPI 1326017492
  NPD
• Tracey W. Childers, D.O. P.C.

  • Otolaryngology Physician
  • Tahlequah, OK
  • NPI 1720274699
  NPD (past)

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

• Adair County Health Center, Inc.

  • Rural Acute Care Hospital
  • Stilwell, OK
  • NPI 1790753358
  Care Compare affiliation
• Northeastern Health System

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1003865999
  Care Compare affiliation
• Northeastern Health System

  • Rural Health Clinic/Center
  • Fort Gibson, OK
  • NPI 1013458652

  Hospital

  Care Compare affiliation
• Northeastern Health System

  • Rural Health Clinic/Center
  • Tahlequah, OK
  • NPI 1306387949

  Hospital

  Care Compare affiliation
• Northeastern Health System

  • Addiction (Substance Use Disorder) Counselor
  • Tahlequah, OK
  • NPI 1689338519

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1730227299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 E ROSS BYP",
            "address_2": "SUITE A",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644133",
            "telephone_number": "918-453-1234",
            "fax_number": "918-453-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 E ROSS BYP",
            "address_2": "SUITE A",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644133",
            "telephone_number": "918-453-1234",
            "fax_number": "918-453-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "PHILIP",
        "middle_name": "DEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-04",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200070490 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200129810A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Ashley Washington, RN
• Jennie Shae Washington
• Sarah Courtney Watkins, PHARM.D.
• Dawn Watson, PARAPROFESSIONAL
• Kimberly Ann Watson, NP-C
• Dorie Elizabeth Watters, BSW
• Chana Watts
• Alexandria Gabrielle Weaver
• Geoff D Webb, BACHELORS OF ARTS
• Robert Paul Webb III, DDS

• Medical Physician Assistant in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.