Cristyn Watkins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2009016625 Issued in MO

Practice address

5001 Lake Ave
Saint Joseph
Saint Joseph, MO 64504-1170

Phone

(816) 238-7788

Fax

(816) 238-9285

NPI assigned

May 16, 2008

Last updated

Jun 1, 2010By 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

Other identifiers 2

Other names 1

• Cristyn Glidewell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 1, 2017 through May 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: cristyn.watkins@direct.mymlc.com

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1790942910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LAKE AVE",
            "address_2": "SAINT JOSEPH",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645041170",
            "telephone_number": "816-238-7788",
            "fax_number": "816-238-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 LAKE AVE",
            "address_2": "SAINT JOSEPH",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645041170",
            "telephone_number": "816-238-7788",
            "fax_number": "816-238-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "CRISTYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009016625",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-33784",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200614390A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790942910",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTYN",
            "last_name": "GLIDEWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Wanyonyi, PHARMD
• David G Ward, M.D.
• Summer Ward, LPC
• Kaitlyn Warden, PHARMD
• Carsten Warner
• Linda Lee Watson, P.T.
• Richard Alan Watson, M.D.
• Valerie Watts, FNP-C
• Jonathan I Wear, PHARM.D.
• Brandi Nicole Weaver, NP

• Family Medicine Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.