Teressa McKoy Watts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9600299 Issued in NC

Practice address

9908 Couloak Dr
Suite 202
Charlotte, NC 28216-8678

Phone

(704) 801-3050

Fax

(704) 801-3026

NPI assigned

Jul 20, 2006

Last updated

Oct 28, 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 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1932129053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601067",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601067",
            "telephone_number": "704-801-3050",
            "fax_number": "704-801-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9908 COULOAK DR",
            "address_2": "SUITE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168678",
            "telephone_number": "704-801-3050",
            "fax_number": "704-801-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "TERESSA",
        "middle_name": "MCKOY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9600299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "1003C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891003C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932129053",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larica Watts
• Larry T. Watts, MD
• Latasha Denise Watts, LCSW
• Logan Elizabeth Watts, FNP-C
• Meta Felice Watts, COTA/L
• Waveco LLC (Carolina Center for Specialty Surgery)
• Waverly Surgery Center, PA
• Dael Waxman, MD
• Brooke Mary Way
• Lauren Elaine Kenley Wayenberg, LCSWA

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.