NPIMap

Individual provider Active NPI

Nichole McCullough Watson, M.D.

  • Family Medicine Physician
  • Mount Pleasant, SC
National Provider Identifier
1881034361
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38882 Issued in SC
Practice address
3510 N Highway 17
Ste. 320
Mt Pleasant, SC 29466-8227
Phone
(843) 971-3361
Fax
(843) 606-8003
NPI assigned
Jun 28, 2013
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38882 SC Primary

Addresses

Primary practice location

3510 N Highway 17
Ste. 320
Mt Pleasant, SC 29466-8227

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other practice location 1

631 Venning St
Mc Clellanville, SC 29458-9710
Phone (843) 887-3344

Other identifiers 1

IdentifierTypeStateIssuer
388823MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Nichole.Watson@rsfpp.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20160718001930 SC Practitioner - Family Practice 9830482538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3510 N Hwy 17
Suite 320
Mount Pleasant, SC 29466-8232
Phone (843) 971-3361

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38882SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Family Medicine CurrentSince Jul 25, 2016 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jul 25, 2016 Accepting new patients
Roper Saint Francis Physicians Network Family Medicine Past Accepting new patients

Locations

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

3510 N Highway 17
Ste 320
Mt Pleasant, SC 29466
Phone (843) 971-3361

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: nichole.watson@rsfpp.eclinicaldirectplus.com
  • Direct secure messaging: nwatson1236680@direct.bsmhealth.org

Organizations & group practices 4

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 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": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1881034361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N HIGHWAY 17",
            "address_2": "STE. 320",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294668227",
            "telephone_number": "843-971-3361",
            "fax_number": "843-606-8003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Venning St",
            "address_purpose": "LOCATION",
            "city": "Mc Clellanville",
            "state": "SC",
            "postal_code": "294589710",
            "country_code": "US",
            "telephone_number": "843-887-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "NICHOLE",
        "middle_name": "MCCULLOUGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "38882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388823",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nichole.Watson@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "3510 N Highway 17",
            "address_2": "Ste. 320",
            "city": "MT Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294668227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.