Active NPI
Nathaniel R Watts, DO
- Family Medicine Physician
- Fort Campbell, KY
National Provider Identifier
1790124915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS12871
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (270) 798-3969
- NPI assigned
- Jun 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS12871 | FL | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
405 Tranquill LN
Clarksville, TN 37043-6732
Phone (813) 484-2713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200131000353 | NC | Order and Referring Only - Family Practice | 8820424310 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1790124915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 TRANQUILL LN",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370436732",
"telephone_number": "813-484-2713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "270-798-3969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "NATHANIEL",
"middle_name": "R",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-20",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS12871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.