NPIMap

Individual provider Active NPI

Kenneth Leroy Watts, MD

  • Surgery Physician
  • Joplin, MO
National Provider Identifier
1790992261
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2013032884 Issued in MO
Practice address
100 Mercy Way Ste 440
Joplin, MO 64804-4524
Phone
(417) 781-4404
NPI assigned
May 16, 2007
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2013032884 MO Primary
Surgery Physician 208600000X 25530 OK

Addresses

Primary practice location

100 Mercy Way Ste 440
Joplin, MO 64804-4524

Mailing address

100 Mercy Way Ste 440
Joplin, MO 64804-4524
Phone (417) 781-4404

Other identifiers 1

IdentifierTypeStateIssuer
200116470AMedicaidOK

Other names 1

  • Kenny Leroy Watts Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070917000088 OK Practitioner - General Surgery 9133213531 Reassigns benefits to 1 organization
I20100913000727 TX Practitioner - General SurgeryPractitioner - Other (Physician) 9133213531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Dakota School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

310 2ND Ave SW
208 Integris Srgns Clin
Miami, OK 74354-6702
Phone (918) 540-7870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions23
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Nov 8, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Nov 8, 2021 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Dec 30, 2024 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Integris Miami Hospital Past Accepting new patients
Kenneth L Watts MD PC Surgery PastSince Jul 1, 2007 Accepting new patients
Acute Surgical Care Specialists PLLC Surgery Past Accepting new patients
Cherokee Nation Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Elective Surgical Care Specialists,PLLC Surgery Past Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

310 2nd Ave SW
Ste 208
Miami, OK 74354
Phone (918) 540-7655

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: kwatts519528@direct.integrisok.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1790992261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY STE 440",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY STE 440",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "KENNETH",
        "middle_name": "LEROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2013032884",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "25530",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200116470A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNY",
            "last_name": "WATTS",
            "middle_name": "LEROY",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.