Individual provider Active NPI

Robert James Watson V, DC

  • Chiropractor
  • Highland, IN
National Provider Identifier
1861983769
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003033 Issued in IN
Practice address
2022 45TH Street
Highland, IN 46322-4200
Phone
(219) 227-4033
Fax
(708) 931-0119
NPI assigned
May 25, 2018
Last updated
Sep 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003033 IN Primary

Addresses

Primary practice location

2022 45TH Street
Highland, IN 46322-4200

Mailing address

2022 45TH Street
Highland, IN 46322-4200
Phone (219) 227-4033

Other practice location 1

9200 Calumet Ave Ste N502
Munster, IN 46321-2862
Phone (219) 440-5286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180608001151 IN Practitioner - ChiropracticPractitioner - Sports Medicine 4486909785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Sports Medicine
Education
Logan College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

9200 Calumet Ave
Suite N502
Munster, IN 46321-2862
Phone (219) 836-4473

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003033INMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Nov 1, 2019 Accepting new patients

Locations

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9200 Calumet Ave
Ste N502
Munster, IN 46321
Phone (219) 440-5286

1545 W US Highway 30
Schererville, IN 46375
Phone (219) 703-2440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1861983769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 45TH STREET",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463224200",
            "telephone_number": "219-227-4033",
            "fax_number": "708-931-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 45TH STREET",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463224200",
            "telephone_number": "219-227-4033",
            "fax_number": "708-931-0119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 Calumet Ave Ste N502",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212862",
            "country_code": "US",
            "telephone_number": "219-440-5286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_suffix": "V",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

Verify at the official NPI Registry.