Mikaela Rose Watkins

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008779 Issued in VA

Practice address

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178

Phone

(757) 507-4123

NPI assigned

Jan 6, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mikaela R Watkins Other name

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment NPD

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1760143267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 GLENN MITCHELL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560178",
            "telephone_number": "757-507-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GLENN MITCHELL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560178",
            "telephone_number": "757-507-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "MIKAELA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKAELA",
            "last_name": "WATKINS",
            "middle_name": "R",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heather Wathen, ATC
• Mercy Rivera Wathen
• Alexis Watkins
• Irhonda Watkins
• Kyra Letia Watkins
• Sydney Watkins
• Ashley Watson, NP-C
• Essence Latrice Watson, PHARMD
• James Christopher Watson Jr.
• Jennifer Rose Watson, M.P.T.

• Physician Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.