Individual provider Active NPI

Athena Watson, LPN

  • Licensed Practical Nurse
  • Ft. Rucker, AL
National Provider Identifier
1881984789
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2-059955 Issued in AL
Practice address
Building 301 Andrews Avenue
Lyster Army Health Clinic
Ft. Rucker, AL 36362-5333
Phone
(334) 255-7000
NPI assigned
Apr 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2-059955 AL Primary

Addresses

Primary practice location

Building 301 Andrews Avenue
Lyster Army Health Clinic
Ft. Rucker, AL 36362-5333

Mailing address

Building 301 Andrews Avenue
Lyster Army Health Clinic
Ft. Rucker, AL 36362-5333
Phone (334) 255-7000

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

State licenses

LicenseStateTypeSpecialty
2-059955ALMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1881984789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BUILDING 301 ANDREWS AVENUE",
            "address_2": "LYSTER ARMY HEALTH CLINIC",
            "city": "FT. RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 301 ANDREWS AVENUE",
            "address_2": "LYSTER ARMY HEALTH CLINIC",
            "city": "FT. RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ATHENA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AL",
            "license": "2-059955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.