Active NPI
Jerry Franklin Watson, MD
- Surgery Physician
- N Wilkesboro, NC
National Provider Identifier
1962480293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 17810
- Practice address
- 301 8TH St
N Wilkesboro, NC 28659-4127 - Phone
- (336) 667-1183
- Fax
- (336) 667-4836
- NPI assigned
- Jan 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 17810 | NC | Primary |
Addresses
Primary practice location
301 8TH St
N Wilkesboro, NC 28659-4127
Mailing address
PO Box 818
301 8TH St
N Wilkesboro, NC 28659-0818
Phone (336) 667-1183
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8985985 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17810 | NC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962480293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 818",
"address_2": "301 8TH ST",
"city": "N WILKESBORO",
"state": "NC",
"postal_code": "286590818",
"telephone_number": "336-667-1183",
"fax_number": "336-667-4836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 8TH ST",
"city": "N WILKESBORO",
"state": "NC",
"postal_code": "286594127",
"telephone_number": "336-667-1183",
"fax_number": "336-667-4836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "JERRY",
"middle_name": "FRANKLIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "17810",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8985985",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in N Wilkesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.