Jessica Leigh Watson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2054 Issued in SC

Practice address

2114 Highway 41 Ste 105
Mount Pleasant, SC 29466

Phone

(843) 388-9000

Fax

(843) 388-6937

NPI assigned

Nov 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sea Island Medical CareGroup PAC ID 0941540819, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sea Island Medical Care

  • Primary Care Clinic/Center
  • Mount Pleasant, SC
  • NPI 1528561453
  Medicare reassignment Care Compare group
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  SC

  Medicare reassignment
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1285673269
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Mt Pleasant, SC
  • NPI 1841801149
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1932437662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 HIGHWAY 41 STE 105",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294666201",
            "telephone_number": "843-388-9000",
            "fax_number": "843-388-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 HIGHWAY 41 STE 105",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29466",
            "telephone_number": "843-388-9000",
            "fax_number": "843-388-6937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1241 Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643288",
            "country_code": "US",
            "telephone_number": "843-990-4414",
            "fax_number": "843-990-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2054",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1848PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC3066I711",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "provider@seaislandmedical.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2114 Highway 41 Ste 105",
            "city": "Mount Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colene L Watkins, PA-C
• Hollyn Elizabeth Watkins, M.S. CCC-SLP
• Jordan Watkins, LISW-CP
• Charlene Watson
• Courtney Diane Watson, PHARMD
• Joshua Thomas Watson, M.D.
• Nichole McCullough Watson, M.D.
• Lisa Marie Watt, OTR/L
• Ryley Elizabeth Watt, AUD
• Waves Counseling LLC

• Medical Physician Assistant in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.
• 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.