Carolyn C Watterworth, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN161162 Issued in OH

Practice address

1141 N Monroe Dr
Xenia, OH 45385

Phone

(937) 372-8011

Fax

(937) 376-6983

NPI assigned

Jan 30, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Consolidated Anesthesiologists Inc

  dba Anesthesia Associates Of Northwest Dayton Inc

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1952377798

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Mont Green Anesthesiology Inc

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1750352159

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740251446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951568",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44193",
            "telephone_number": "937-293-0247",
            "fax_number": "937-293-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N MONROE DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "45385",
            "telephone_number": "937-372-8011",
            "fax_number": "937-376-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERWORTH",
        "first_name": "CAROLYN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN161162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00281504",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000381924",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806980",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Waters
• Waterstreet Family Practice, Inc.
• Amber Watson
• Jerrod J Watson
• Nicole Watson
• Shondelle Watts
• Cristel D Wead, LSW
• Tia Webb, LPCC
• Jeremy Webster
• Mark D Webster, PA-C

• Certified Registered Nurse Anesthetist in Xenia, OH
• Providers in Xenia, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.