Kyle Alan Watterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25516 Issued in FL

Practice address

12901 Bruce B Downs Blvd
Mdc90
Tampa, FL 33612-4742

Phone

(813) 974-8613

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1831107267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770",
            "telephone_number": "813-974-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "address_2": "MDC90",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-974-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERSON",
        "first_name": "KYLE",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT25516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002181900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y04N6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert A Watson, MD
• Anthony W Watt, M.D.
• Joseph E Watters, PA-C
• Jessica E Watterson, PTA
• Kathryn Ruth Watterson, CRNA
• Sherri J Watterson, PTA
• Emelia Katharine Watts, MD
• Esveida Mariel Watts
• Francine Bass Watts, MS CCC SLP
• Stephanie Anne Watts, M.S., CFY-SLP

• Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.