Individual provider Active NPI

Annette Watson, MD

  • Pediatrics Physician
  • Marrero, LA
National Provider Identifier
1811911191
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-061600-L Issued in PA
Practice address
1111 Medical Center Blvd Ste N208
Marrero, LA 70072-3153
Phone
(504) 349-6228
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-061600-L PA Primary

Addresses

Primary practice location

1111 Medical Center Blvd Ste N208
Marrero, LA 70072-3153

Mailing address

120 Ochsner Blvd Ste 100
Gretna, LA 70056-5247
Phone (504) 391-7565

Other identifiers 1

IdentifierTypeStateIssuer
001755816MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-061600-LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Haydel MD a Medical Corporation Pediatrics CurrentSince Aug 13, 2023 Accepting new patients

Locations

120 Ochsner Blvd
Ste 100
Gretna, LA 70056
Phone (504) 290-8330

1111 Medical Center Blvd
Ste 208
Marrero, LA 70072

1111 Medical Center Blvd
Ste N
Marrero, LA 70072

1111 Medical Center Blvd
Ste 2
Marrero, LA 70072

1111 Medical Center Blvd
Ste N208
Marrero, LA 70072
Phone (504) 349-6228

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1811911191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OCHSNER BLVD STE 100",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565247",
            "telephone_number": "504-391-7565",
            "fax_number": "504-391-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD STE N208",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723153",
            "telephone_number": "504-349-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD-061600-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001755816",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.