Individual provider Active NPI

Nardia Nichola Watson, MSN, FNP

  • Family Nurse Practitioner
  • Union City, GA
National Provider Identifier
1770538860
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN150932NP Issued in GA
Practice address
4910 Jonesboro Rd
BLDG 700 Suite 1
Union City, GA 30291-2085
Phone
(770) 964-7736
Fax
(770) 306-1726
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN150932NP GA Primary

Addresses

Primary practice location

4910 Jonesboro Rd
BLDG 700 Suite 1
Union City, GA 30291-2085

Mailing address

417 Harvick Cir
Stockbridge, GA 30281-4451
Phone (678) 289-4819

Other identifiers 1

IdentifierTypeStateIssuer
2477MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20061127000113 GA Practitioner - Nurse Practitioner 8224040795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN150932NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yvonne L. Smith MD PC CurrentSince Jan 1, 2008 Accepting new patients

Locations

4910 Jonesboro Rd
Union City, GA 30291
Phone (770) 557-5144

4910 Jonesboro Rd
Bldg 700
Union City, GA 30291
Phone (770) 964-7736

Interoperability endpoints

  • Direct secure messaging: nardia.watson@rapm.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1770538860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 HARVICK CIR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814451",
            "telephone_number": "678-289-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 JONESBORO RD",
            "address_2": "BLDG 700 SUITE 1",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912085",
            "telephone_number": "770-964-7736",
            "fax_number": "770-306-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "NARDIA",
        "middle_name": "NICHOLA",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN150932NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2477",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, GA

Sources for this page

Verify at the official NPI Registry.