Individual provider Active NPI

Kathryn Deacon Watts, CRNP

  • Registered Nurse
  • Annapolis, MD
National Provider Identifier
1790098853
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R176362 Issued in MD
Practice address
600 Ridgely Ave Ste 130
Annapolis, MD 21401-1045
Phone
(410) 266-8049
Fax
(410) 266-0787
NPI assigned
Jul 19, 2010
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R176362 MD Primary

Addresses

Primary practice location

600 Ridgely Ave Ste 130
Annapolis, MD 21401-1045

Mailing address

600 Ridgely Ave Ste 130
Annapolis, MD 21401-1045
Phone (410) 266-8049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20101206000678 MD Practitioner - Nurse Practitioner 3779770557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anne Arundel Urology, PAGroup PAC ID 9032178918, 33 clinicians

Practice addresses (Care Compare)

600 Ridgely Ave
Suite 130
Annapolis, MD 21401-1045
Phone (410) 266-8049

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R176362MDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Arundel Urology, PA CurrentSince Jul 30, 2014 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

600 Ridgely Ave
Ste 130
Annapolis, MD 21401
Phone 4102668049157

600 Ridgely Ave
Ste 222223
Annapolis, MD 21401
Phone (410) 266-0895

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1790098853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 RIDGELY AVE STE 130",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011045",
            "telephone_number": "410-266-8049",
            "fax_number": "410-266-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 RIDGELY AVE STE 130",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011045",
            "telephone_number": "410-266-8049",
            "fax_number": "410-266-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "KATHRYN",
        "middle_name": "DEACON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R176362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.