Individual provider Active NPI

Patricia Lynn Gist-Watson, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1881618320
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD051296L Issued in PA
Practice address
6643 Chew Ave
Philadelphia, PA 19119-2004
Phone
(215) 844-5437
Fax
(215) 844-4722
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD051296L PA Primary

Addresses

Primary practice location

6643 Chew Ave
Philadelphia, PA 19119-2004

Mailing address

144 Westgate Drive
North Wales, PA 19454-4209
Phone (215) 844-5437

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD051296LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidcare Pediatrics, Inc. Pediatrics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1881618320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 WESTGATE DRIVE",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194544209",
            "telephone_number": "215-844-5437",
            "fax_number": "215-844-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6643 CHEW AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192004",
            "telephone_number": "215-844-5437",
            "fax_number": "215-844-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIST-WATSON",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD051296L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.