Active NPI
Raymond Andre Watson, DC
- Rehabilitation Chiropractor
- Las Vegas, NV
National Provider Identifier
1891199097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- B01539
- Practice address
- 10925 Southern Highlands Pkwy
Unit 2150
Las Vegas, NV 89141-4302 - Phone
- (702) 885-3553
- NPI assigned
- Oct 17, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | B01539 | NV | |
| Rehabilitation Chiropractor | 111NR0400X | B01539 | NV | Primary |
| Sports Physician Chiropractor | 111NS0005X | B01539 | NV | |
| Orthopedic Chiropractor | 111NX0800X | B01539 | NV |
Addresses
Primary practice location
10925 Southern Highlands Pkwy
Unit 2150
Las Vegas, NV 89141-4302
Mailing address
4065 S Maryland Pkwy
Suite C
Las Vegas, NV 89119-7538
Phone (702) 885-3553
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
| License | State | Type | Specialty |
|---|---|---|---|
| B01539 | NV | MD | Orthopedic Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1891199097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4065 S MARYLAND PKWY",
"address_2": "SUITE C",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891197538",
"telephone_number": "702-885-3553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10925 SOUTHERN HIGHLANDS PKWY",
"address_2": "UNIT 2150",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891414302",
"telephone_number": "702-885-3553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "RAYMOND",
"middle_name": "ANDRE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "NV",
"license": "B01539",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "NV",
"license": "B01539",
"primary": true
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "NV",
"license": "B01539",
"primary": false
},
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "NV",
"license": "B01539",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.