NPIMap

Individual provider Active NPI

Ian Watson, NP

  • Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1871052050
Registry record updated Feb 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP141005 Issued in TX
Practice address
2600 Saint Michael Dr
Texarkana, TX 75503-5220
Phone
(903) 614-1000
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP211618 ME
Nurse Practitioner 363L00000X AP141005 TX Primary

Addresses

Primary practice location

2600 Saint Michael Dr
Texarkana, TX 75503-5220

Mailing address

5410 Maryland Way Ste 300
Brentwood, TN 37027-5339
Phone (615) 377-1705

Other practice location 1

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7018

Other identifiers 1

IdentifierTypeStateIssuer
AP141005OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826002123 TX Practitioner - Nurse Practitioner 3971831124 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Boston Medical Group, LLPGroup PAC ID 0446230635, 4 clinicians

Practice addresses (Care Compare)

114 W US Hwy 82
New Boston, TX 75570-2804
Phone (903) 628-0422

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Texas, PA Nurse Practitioner CurrentSince May 7, 2019 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince May 7, 2019 Accepting new patients
New Boston Medical Group LLP CurrentSince Feb 1, 2022 Accepting new patients
New Boston Medical Group LLP Nurse Practitioner CurrentSince Feb 1, 2022 Accepting new patients
Watson Health & Wellness LLC Current Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

114 W US Highway 82
New Boston, TX 75570
Phone (903) 628-0422

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 5

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 7

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1871052050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275339",
            "telephone_number": "615-377-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035220",
            "telephone_number": "903-614-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-283-7018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "IAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-02-13",
        "certification_date": "2022-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP211618",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP141005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP141005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.