NPIMap

Individual provider Active NPI

Eric James Watson, MD

  • Internal Medicine Physician
  • Saint George, SC
National Provider Identifier
1952474769
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13161 Issued in SC
Practice address
202 Gavin St
St George, SC 29477
Phone
(843) 563-3512
Fax
(843) 563-4464
NPI assigned
Nov 17, 2006
Last updated
Nov 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13161 SC Primary

Addresses

Primary practice location

202 Gavin St
St George, SC 29477

Mailing address

202 Gavin St
St George, SC 29477
Phone (843) 563-3512

Other identifiers 1

IdentifierTypeStateIssuer
131618MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20100929001125 SC Practitioner - Internal Medicine 6709864952 Practice locations: Saint George, SC

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Brody School of Medicine at East Carolina University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 Gavin St
Saint George, SC 29477-2403
Phone (843) 563-3512

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13161SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Santhill Diagnostics, LLC PastSince Nov 1, 2003 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1952474769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GAVIN ST",
            "city": "ST GEORGE",
            "state": "SC",
            "postal_code": "29477",
            "telephone_number": "843-563-3512",
            "fax_number": "843-563-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 GAVIN ST",
            "city": "ST GEORGE",
            "state": "SC",
            "postal_code": "29477",
            "telephone_number": "843-563-3512",
            "fax_number": "843-563-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ERIC",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "13161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131618",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, SC

Sources for this page

Verify at the official NPI Registry.