Courtney Elizabeth Watza

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301502459 Issued in MI

Practice address

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265

Phone

(314) 623-9266

NPI assigned

Apr 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Elizabeth Chase Former name

Medicare fee-for-service enrollment

Enrolled in MI, MO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Pediatrics

  Medicare reassignment NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549
  Medicare reassignment NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1891228557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-623-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-623-9266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012166",
            "country_code": "US",
            "telephone_number": "313-832-8290",
            "fax_number": "313-993-0081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATZA",
        "first_name": "COURTNEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-09",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301502459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "CHASE",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Watts, PHARM.D.
• Kristen Watts, DDS
• Patrina Letise Watts, LPN
• Chiedozie Ikenna Anochi Waturuocha, MD
• Isabel Ann Watz
• Donovan Watza, MD, PHD
• Rebecca Mae Waugh
• Hannah Marie Wavering-Walters, MD
• Daria Rai Wawrzyniak, WHNP
• Harold Fred Waxman

• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.