Individual provider Active NPI

Shawn Todd Watson, M.D.

  • Emergency Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1811938467
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
17232 Issued in MS
Practice address
5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone
(225) 765-7163
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17232 MS Primary

Addresses

Primary practice location

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375

Mailing address

7128 Boyce Dr
Baton Rouge, LA 70809-1153
Phone (225) 924-1821

Other identifiers 2

IdentifierTypeStateIssuer
1486299MedicaidLA
P00659887OtherLARAILROAD MCARE THRU PEPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080429000964 LA Practitioner - Emergency Medicine 2567461502 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17232MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gitter Vein Institute CurrentSince May 1, 2023 Accepting new patients
Ascension Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Center for Vein Restoration la LLC PastSince Jul 28, 2024 Accepting new patients
C & M Medical Services, Inc. Past Accepting new patients

Locations

10101 Siegen Ln
Bldg 3B
Baton Rouge, LA 70810
Phone (225) 288-1230

1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975

1 Galleria Blvd
Ste 100
Metairie, LA 70001
Phone (504) 833-0111

2525 Severn Ave
Fl 4
Metairie, LA 70002
Phone (504) 780-0982

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1811938467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7128 BOYCE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091153",
            "telephone_number": "225-924-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HENNESSY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084375",
            "telephone_number": "225-765-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SHAWN",
        "middle_name": "TODD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "17232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1486299",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE THRU PEPA",
            "identifier": "P00659887",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.