Individual provider Active NPI

Randi Marie Watson, M.S., CCC/SLP

  • Speech-Language Pathologist
  • Texarkana, TX
National Provider Identifier
1962982777
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
111763 Issued in TX
Practice address
600 W 52ND St
Texarkana, TX 75503-2980
Phone
(903) 792-6700
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 111763 TX Primary

Addresses

Primary practice location

600 W 52ND St
Texarkana, TX 75503-2980

Mailing address

600 W 52ND St
Texarkana, TX 75503-2980
Phone (903) 792-6700

Other practice location 1

1401 Hampton Rd
Texarkana, TX 75503-4600
Phone (903) 792-7994

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
111763TXMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1962982777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 52ND ST",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032980",
            "telephone_number": "903-792-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 52ND ST",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032980",
            "telephone_number": "903-792-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Hampton Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755034600",
            "country_code": "US",
            "telephone_number": "903-792-7994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "RANDI",
        "middle_name": "MARIE",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.