Individual provider Active NPI

Toby Tyler Watson, PSY.D.

  • Clinical Psychologist
  • Sheboygan, WI
National Provider Identifier
1831537307
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2563-057 Issued in WI
Practice address
2808 Kohler Memorial Drive
Suite 1
Sheboygan, WI 53081-3166
Phone
(920) 208-7226
NPI assigned
Jun 6, 2013
Last updated
Jun 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2563-057 WI Primary
Forensic Psychologist 103TF0200X 2563-057 WI

Addresses

Primary practice location

2808 Kohler Memorial Drive
Suite 1
Sheboygan, WI 53081-3166

Mailing address

2808 Kohler Memorial Dr
Suite 1
Sheboygan, WI 53081-3177
Phone (920) 208-7226

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

State licenses

LicenseStateTypeSpecialty
2563-057WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Psychological Health Services Clinical Past Accepting new patients

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, 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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1831537307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 KOHLER MEMORIAL DR",
            "address_2": "SUITE 1",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813177",
            "telephone_number": "920-208-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 KOHLER MEMORIAL DRIVE",
            "address_2": "SUITE 1",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813166",
            "telephone_number": "920-208-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TOBY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2563-057",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WI",
            "license": "2563-057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.