Shannon Watkins, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

41396 Issued in KY

Practice address

1065 Ashley St
Suite 200
Bowling Green, KY 42103-3400

Phone

(270) 781-5111

Fax

(270) 780-0478

NPI assigned

Nov 27, 2006

Last updated

Jul 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Miss Shannon Renee Wright Former name

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Specialty

Dermatology

Education

University of Louisville School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannonwatkins@ggc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Graves Gilbert Clinic PLLC

  dba Graves Gilbert Clinic

  • Specialist
  • Bowling Green, KY
  • NPI 1114948288
  Medicare reassignment Care Compare group NPD
• Graves Gilbert Clinic PLLC

  dba GGC Rural Health Clinic Cave City

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663
  NPD
• Advanced Sleep Consultants of Middle TN, Inc

  • Medical Specialty Clinic/Center
  • Lebanon, TN
  • NPI 1912048307
  NPD (past)
• Cumberland Skin Surgery and Dermatology

  • Medical Specialty Clinic/Center
  • Lebanon, TN
  • NPI 1922138247
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1902972441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 ASHLEY ST",
            "address_2": "SUITE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033400",
            "telephone_number": "270-781-5111",
            "fax_number": "270-780-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 ASHLEY ST",
            "address_2": "SUITE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033400",
            "telephone_number": "270-781-5111",
            "fax_number": "270-780-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME 97022",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "41396",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "45270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100046110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WRIGHT",
            "middle_name": "RENEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert J. Wasson, M.D.
• Carl Edwin Waters
• Alice J Wathen
• James Wathen, PEER SUPPORT REP
• Ashya Denise Watkins
• Alexis L Watson
• Chelsea Watson, DPT
• Tasha Watson
• Max Way
• Molly Way

• Dermatology Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.