Individual provider Active NPI

Adelle Alexandria Maynard - Watts, D.O.

  • Neurology Physician
  • Terre Haute, IN
National Provider Identifier
1881949576
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
02004787A Issued in IN
Practice address
1739 N 4TH St
Terre Haute, IN 47804-4002
Phone
(812) 242-1000
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 02004787A IN Primary

Addresses

Primary practice location

1739 N 4TH St
Terre Haute, IN 47804-4002

Mailing address

1301 Clover CT
Terre Haute, IN 47802-9042
Phone (812) 201-5561

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
I20160705000707 IN Practitioner - Neurology 8123266731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1739 N 4TH St
Apands Northside
Terre Haute, IN 47804-4002
Phone (812) 242-3600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Union Associated Physicians Clinic LLC CurrentSince Jun 1, 2016 Accepting new patients
Union Hospital Inc. Current Accepting new patients
Union Associated Physicians Clinic, LLC CurrentSince Jun 1, 2016 Accepting new patients

Locations

221 S 6th St
Terre Haute, IN 47807
Phone (812) 242-3157

1429 N 6th St
Terre Haute, IN 47807
Phone (812) 242-3115

1530 N 7th St
Ste 500
Terre Haute, IN 47807
Phone (812) 238-4555

1739 N 4th St
Terre Haute, IN 47804
Phone (812) 235-3024

Interoperability endpoints

  • Direct secure messaging: amaynardwatts@unionhealth.cernerdirect.com

Organizations & group practices 3

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1881949576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CLOVER CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478029042",
            "telephone_number": "812-201-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 N 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044002",
            "telephone_number": "812-242-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD - WATTS",
        "first_name": "ADELLE",
        "middle_name": "ALEXANDRIA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "02004787A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.