Individual provider Active NPI

John Andrew Watson, D.O.

  • Emergency Medicine Physician
  • McComb, MS
National Provider Identifier
1851370795
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13501 Issued in MS
Practice address
1017 Delaware Ave
McComb, MS 39648-3827
Phone
(601) 250-1122
Fax
(601) 250-0290
NPI assigned
Jan 10, 2006
Last updated
Feb 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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 13501 MS Primary

Addresses

Primary practice location

1017 Delaware Ave
McComb, MS 39648-3827

Mailing address

1017 Delaware Ave
McComb, MS 39648-3827
Phone (601) 250-1122

Other identifiers 1

IdentifierTypeStateIssuer
930047834OtherMSMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20101004001117 MS Practitioner - Emergency MedicinePractitioner - Family Practice 3678578770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
West Virginia School of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statcare PLLCGroup PAC ID 5799764965, 9 clinicians

Practice addresses (Care Compare)

1017 Delaware Ave
McComb, MS 39648-3827
Phone (601) 250-1122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
52.64 of 100Reported as individual
Quality
66.93
Improvement activities
0
Cost
86.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare PLLC Emergency Medicine CurrentSince Sep 4, 1997 Accepting new patients

Locations

1015 Delaware Ave
Ste C
McComb, MS 39648
Phone (601) 249-4777

1017 Delaware Ave
McComb, MS 39648
Phone (601) 250-1122

208 W Presley Blvd
#A
McComb, MS 39648
Phone (601) 465-0745

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: jwatson@sp-ms.direct.office.nextgen.com

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.

Hospital & facility affiliations 4

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1851370795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 DELAWARE AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483827",
            "telephone_number": "601-250-1122",
            "fax_number": "601-250-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 DELAWARE AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483827",
            "telephone_number": "601-250-1122",
            "fax_number": "601-250-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "13501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "930047834",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.