Active NPI
James E Watson, MD
- Gynecology Physician
- Willimantic, CT
National Provider Identifier
1881797975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 014648
- Practice address
- 112 Mansfield Ave
Willimantic, CT 06226-2045 - Phone
- (860) 456-6796
- NPI assigned
- Sep 6, 2006
- Last updated
- Aug 27, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 014648 | CT | Primary |
Addresses
Primary practice location
112 Mansfield Ave
Willimantic, CT 06226-2045
Mailing address
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 456-6796
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001146489 | Medicaid | CT |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014648 | CT | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1881797975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 MANSFIELD AVE",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062262045",
"telephone_number": "860-456-6796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 MANSFIELD AVE",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062262045",
"telephone_number": "860-456-6796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "JAMES",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CT",
"license": "014648",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001146489",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.