Mark Darryl Watkins, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

21461 Issued in TN

Practice address

414 Greenbelt Dr
Maryville, TN 37804-5702

Phone

(865) 982-0032

Fax

(866) 307-8963

NPI assigned

Jul 7, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1780616664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 GREENBELT DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045702",
            "telephone_number": "865-982-0032",
            "fax_number": "866-307-8963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Mountain View Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Vonore",
            "state": "TN",
            "postal_code": "378852666",
            "country_code": "US",
            "telephone_number": "423-884-2170",
            "fax_number": "866-330-9583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "MARK",
        "middle_name": "DARRYL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "21461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516091",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janell Waller
• Donald Lance Ward
• Douglas K. Warner, M.D.
• Melody Wong Warren, NP-C
• Jordan Rae Watkins
• Rebecca P Watkins
• Sarah M. Watkins, O.D.
• Hope Elizabeth Watson, DMD
• Kaytlynn Victoria Watson
• Lori J Watson, SLP

• Pediatrics Physician in Maryville, TN
• Providers in Maryville, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.