NPIMap

Individual provider Active NPI

Andrew David Watson, M.D.

  • Family Medicine Physician
  • Quitman, MS
National Provider Identifier
1962664870
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T-2159 Issued in MS
Practice address
603 S Archusa Ave
Quitman, MS 39355-2331
Phone
(601) 776-2123
Fax
(601) 776-6006
NPI assigned
Jul 1, 2008
Last updated
Nov 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T-2159 MS Primary

Addresses

Primary practice location

603 S Archusa Ave
Quitman, MS 39355-2331

Mailing address

PO Box 5208
Meridian, MS 39302-5208
Phone (601) 703-4282

Other identifiers 1

IdentifierTypeStateIssuer
08456238MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20110921000695 MS Practitioner - Family Practice 3476724576 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush Medical FoundationGroup PAC ID 2567368541, 31 clinicians

Practice addresses (Care Compare)

603 S Archusa Ave
Ochsner Health Center Quitman
Quitman, MS 39355-2331
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355-2331
Phone (601) 776-6925

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.18 of 100Reported as group
Quality
78.43
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2159MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laird Hospital, Inc Family Medicine CurrentSince Oct 17, 2013 Accepting new patients
Kemper Cah, Inc CurrentSince Feb 23, 2013 Accepting new patients
Kemper Cah, Inc. Current Accepting new patients
Laird Hospital, Inc. CurrentSince Oct 17, 2013 Accepting new patients
Rush Medical Foundation Family Medicine Current Accepting new patients
Rush Medical Foundation CurrentSince Feb 23, 2013 Accepting new patients
Laird Hospital, Inc. Current Accepting new patients
Rush Medical Foundation CurrentSince Feb 23, 2013 Accepting new patients
Kemper Cah, Inc. CurrentSince Feb 23, 2013 Accepting new patients

Locations

9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874

14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

1710 14th St
Meridian, MS 39301
Phone (601) 703-1485

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925

25117 Highway 15
Union, MS 39365
Phone (601) 774-8214

Organizations & group practices 9

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 6

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1962664870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5208",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025208",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S ARCHUSA AVE",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552331",
            "telephone_number": "601-776-2123",
            "fax_number": "601-776-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "T-2159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08456238",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quitman, MS

Sources for this page

Verify at the official NPI Registry.