Individual provider Active NPI

Jazmyn Grace Watson, PT, DPT

  • Physical Therapist
  • Lutherville, MD
National Provider Identifier
1861235236
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30010 Issued in MD
Practice address
10803 Falls Road Pavilion III, Suite 2100
Lutherville, MD 21093
Phone
(410) 583-2665
Fax
(410) 367-3307
NPI assigned
Jun 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 30010 MD Primary
Physical Therapist 225100000X PT020426 OH

Addresses

Primary practice location

10803 Falls Road Pavilion III, Suite 2100
Lutherville, MD 21093

Mailing address

6201 Greenleigh Ave FL 2
Middle River, MD 21220-2004

Other practice location 1

4924 Campbell Blvd Ste 200
Baltimore, MD 21236-5914
Phone (443) 442-2300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020426OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients
Johns Hopkins Community Physicians CurrentSince Oct 1, 2024 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Oct 1, 2024 Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

6201 Greenleigh Ave
Fl 2
Middle River, MD 21220
Phone (410) 933-2704

4924 Campbell Blvd
Ste 200
Nottingham, MD 21236
Phone (443) 442-2300

10803 Falls Rd
Ste 2100
Timonium, MD 21093
Phone (410) 583-2665

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1861235236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE FL 2",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 FALLS ROAD PAVILION III, SUITE 2100",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "410-583-2665",
            "fax_number": "410-367-3307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4924 Campbell Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212365914",
            "country_code": "US",
            "telephone_number": "443-442-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JAZMYN",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30010",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.