Active NPI
Carol L Watson MD LLC
- Obstetrics & Gynecology Physician
- Enfield, CT
National Provider Identifier
1891984274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 042373
- Legal business name
- CAROL L WATSON MD LLC
- Practice address
- 140 Hazard Avenue
Suite 107
Enfield, CT 06082-4520 - Phone
- (860) 749-4416
- Fax
- (860) 749-4506
- NPI assigned
- Oct 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Deborah L. Bouchard
- Title
- Practice Manager
- Phone
- (860) 749-4416
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 042373 | CT | Primary |
Addresses
Primary practice location
140 Hazard Avenue
Suite 107
Enfield, CT 06082-4520
Mailing address
140 Hazard Ave
Suite 107
Enfield, CT 06082-4520
Phone (860) 749-4416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00142370 | Medicaid | CT |
National Provider Directory
National Provider DirectoryLocations
30 W Avon Rd
Ste A
Avon, CT 06001
Phone (860) 675-6595
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- New Britain, CT
- NPI 1578654976
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1193011200000",
"number": "1891984274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 HAZARD AVE",
"address_2": "SUITE 107",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824520",
"telephone_number": "860-749-4416",
"fax_number": "860-749-4506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HAZARD AVENUE",
"address_2": "SUITE 107",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824520",
"telephone_number": "860-749-4416",
"fax_number": "860-749-4506"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROL L WATSON MD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-22",
"last_updated": "2007-10-22",
"status": "A",
"authorized_official_last_name": "BOUCHARD",
"authorized_official_first_name": "DEBORAH",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "860-749-4416",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "CT",
"license": "042373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00142370",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.