Clyde Watkins Jr., MD, FACP

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036033 Issued in GA

Practice address

5900 Hillandale Drive
Lithonia, GA 30058

Phone

(404) 446-3870

Fax

(404) 446-3875

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal Medicine

Education

Meharry Medical College School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health Home health agency, Fayetteville, GA, CCN 117105
• Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: clyde.watkins.jr.1@21533.direct.athenahealth.com

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.

• Qcpi-Villagemd, PC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment Care Compare group
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Suncrest Home Health of Georgia, Inc

  • Home Health Agency
  • Fayetteville, GA
  • NPI 1801044003
  Care Compare affiliation
• Wellstar Spalding Regional Hospital, Inc

  • General Acute Care Hospital
  • Griffin, GA
  • NPI 1972535318
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851311856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 HILLANDALE DRIVE",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30058",
            "telephone_number": "404-446-3870",
            "fax_number": "404-446-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 HILLANDALE DRIVE",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30058",
            "telephone_number": "404-446-3870",
            "fax_number": "404-446-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "CLYDE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, FACP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "036033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2676968914A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aliyah K Walton
• Pamela Dionne Walton, LPC
• Attalla Ward
• Sharon L Washington, RN
• Yolanda Washington
• Iesha Watkins
• Raven Samone Watkins
• Veronica A Watkins
• Tawanda L Watson
• We Are One Group Home LLC

• Internal Medicine Physician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.