Ladaryl Lorraine Watkins, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904191 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-1000

NPI assigned

Mar 1, 2019

Last updated

Nov 17, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Nurse Practitioner

Education

University of Mississippi School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Foundation of Central Mississippi IncGroup PAC ID 1153216411, 274 clinicians

Baptist Medical Center-Leake, Inc.Group PAC ID 7214102961, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ladaryl.watkins.1@28825.direct.athenahealth.com
• Direct secure messaging: lwatkins369576@direct.bmhcc.org

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.

• Baptist Medical Center-Leake, Inc

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1356626618
  Medicare reassignment Care Compare group NPD
• Medical Foundation of Central Mississippi, Inc.

  dba Baptist Medical Clinics

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Baptist Medical Center-Leake, Inc.

  dba BMC Leake Carthage Primary Care

  • Rural Health Clinic/Center
  • Carthage, MS
  • NPI 1194861260
  NPD
• Medical Foundation of Central Ms

  dba Baptist Medical Clinic-Brandon

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Baptist Medical Center-Leake, Inc

  dba BMC Leake Walnut Grove Primary Care

  • Rural Health Clinic/Center
  • Walnut Grove, MS
  • NPI 1548310782
  NPD (past)

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1760949390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1935 Medical District Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357701",
            "country_code": "US",
            "telephone_number": "214-456-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Highway 16 E",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "MS",
            "postal_code": "390514222",
            "country_code": "US",
            "telephone_number": "601-267-1470",
            "fax_number": "601-267-1469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "LADARYL",
        "middle_name": "LORRAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904191",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MS",
            "license": "908692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimbell Bingham Waters, LCSW
• Watershed Counseling Associates, PLLC
• Angela Watkins
• Beonka Watkins
• Clyde A Watkins Jr., M.D.
• Linda Marie Watkins, N.P.
• Shannon Lauren Watkins, CCC-SLP
• William Marvin Watkins Jr., M.D.
• Watmindusa, Inc.
• Watson Family Dentistry

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.