NPIMap

Individual provider Active NPI

Anita M. Watson, M.D.

  • Pediatrics Physician
  • Cleveland, OH
National Provider Identifier
1902990658
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35058264 Issued in OH
Practice address
8300 Hough Ave
Cleveland, OH 44103-4247
Phone
(216) 231-7700
NPI assigned
Oct 3, 2006
Last updated
Nov 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35058264 OH Primary

Addresses

Primary practice location

8300 Hough Ave
Cleveland, OH 44103-4247

Mailing address

8300 Hough Ave
Cleveland, OH 44103-4247
Phone (216) 231-7700

Other identifiers 1

IdentifierTypeStateIssuer
0749051MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000074 OH Practitioner - Pediatric Medicine 8628193646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35058264OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ohio Neighborhood Health Services, Inc. CurrentSince Aug 8, 2010 Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. CurrentSince Aug 8, 2010 Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. Current Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. Past Accepting new patients

Locations

12100 Superior Ave
Cleveland, OH 44106
Phone (216) 231-7700

4800 Payne Ave
Cleveland, OH 44103
Phone (216) 231-7700

8300 Hough Ave
Cleveland, OH 44103
Phone (216) 231-7700

711 E 222nd St
Euclid, OH 44123
Phone (216) 797-6987

Interoperability endpoints

  • Direct secure messaging: anita.watsonmd.p1@direct.neon.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northeast Ohio Neighborhood Health Services, Inc.Cleveland, OH, CCN 361833 Federally qualified health center Corporate Director Jan 1, 2023
Northeast Ohio Neighborhood Health Services, Inc.Cleveland, OH, CCN 361836 Federally qualified health center Corporate Officer Jan 1, 2013
Northeast Ohio Neighborhood Health Services, Inc.Cleveland, OH, CCN 361832 Federally qualified health center Corporate Officer Jan 1, 2013
Northeast Ohio Neighborhood Health Services, Inc.Cleveland, OH, CCN 361834 Federally qualified health center Corporate Officer Jan 1, 2013
Northeast Ohio Neighborhood Health Services, Inc.Cleveland, OH, CCN 361028 Federally qualified health center Corporate Director Jan 1, 2013
St. Clair Health CenterCleveland, OH, CCN 721812 Federally qualified health center Corporate Officer Jan 1, 2013
Panther Wellness Center-Euclid SBHCEuclid, OH, CCN D21000 Federally qualified health center Corporate Officer Jan 1, 2013
Neon Health SVCS., Medical Mobile UnitCleveland, OH, CCN D21069 Federally qualified health center Corporate Officer Jan 1, 2013

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1902990658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034247",
            "telephone_number": "216-231-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034247",
            "telephone_number": "216-231-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ANITA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35058264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0749051",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.