Individual provider Active NPI

Daniel W. Watson, M. D.

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1841260122
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C6896 Issued in AR
Practice address
904 Autumn Rd
Suite 200
Little Rock, AR 72211-3737
Phone
(501) 227-6363
Fax
(501) 227-8629
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C6896 AR Primary

Addresses

Primary practice location

904 Autumn Rd
Suite 200
Little Rock, AR 72211-3737

Mailing address

904 Autumn Rd
Suite 200
Little Rock, AR 72211-3737
Phone (501) 227-6363

Other identifiers 1

IdentifierTypeStateIssuer
123606001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100415000629 AR Practitioner - Family Practice 0648307116

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

904 Autumn Road
Suite 200
Little Rock, AR 72211-3741

Hospital & facility affiliations

  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C6896ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Autumn Road Family Practice, P.a, CurrentSince Jul 17, 1989 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Past Accepting new patients

Locations

904 Autumn Rd
Ste 200
Little Rock, AR 72211
Phone (501) 227-6363

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22025/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1841260122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 AUTUMN RD",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113737",
            "telephone_number": "501-227-6363",
            "fax_number": "501-227-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 AUTUMN RD",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113737",
            "telephone_number": "501-227-6363",
            "fax_number": "501-227-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DANIEL",
        "middle_name": "W.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C6896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123606001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.