Individual provider Active NPI

Raymond Andre Watson, DC

  • Rehabilitation Chiropractor
  • Las Vegas, NV
National Provider Identifier
1891199097
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
B01539 Issued in NV
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

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
B01539NVMDOrthopedic 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.

Verify at the official NPI Registry.