Active NPI
Keith F Watson, M.D
- Nephrology Physician
- Bloomington, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 01088351A
- Practice address
- 550 S Landmark Ave
Bloomington, IN 47403-3239 - Phone
- (812) 676-4660
- Fax
- (812) 676-4501
- NPI assigned
- Jun 1, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | C0223 | KY | |
| Nephrology Physician | 207RN0300X | E-11140 | AR | |
| Nephrology Physician | 207RN0300X | MD0000035914 | TN | |
| Nephrology Physician | 207RN0300X | 01088351A | IN | Primary |
Addresses
Primary practice location
550 S Landmark Ave
Bloomington, IN 47403-3239
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
911 Bypass Rd Bldg A
Pikeville, KY 41501-1689
Phone (606) 430-2208
Other practice location 2
631 Glenties Drive
Smyrna, TN 37167
Phone (615) 419-7744
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kwatson@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR, ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000
Hospital & facility affiliations
- CHI St Alexius Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-11140 | AR | MD | Nephrology Physician |
| 01088351A | IN | MD | Nephrology Physician |
| C0223 | KY | MD | Nephrology Physician |
| MD0000035914 | TN | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Alexius Medical Center | Current | Accepting new patients | |
| St. Alexius Medical Center | Specialist | Current | Accepting new patients |
| Mercy Clinic Fort Smith Communities | Current | Accepting new patients | |
| Mercy Clinic Fort Smith Communities | Current | Accepting new patients |
Locations
6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000
7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
Organizations & group practices 4
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.
-
- Specialist
- Bismarck, ND
- NPI 1205868429
-
- Multi-Specialty Clinic/Center
- Fort Smith, AR
- NPI 1902073620
-
- Endocrinology, Diabetes & Metabolism Physician
- Fort Smith, AR
- NPI 1790258002
-
- Home Infusion Therapy Pharmacy
- Bismarck, ND
- NPI 1063663607
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bismarck, ND
- NPI 1306832654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1972540557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 S LANDMARK AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474033239",
"telephone_number": "812-676-4660",
"fax_number": "812-676-4501"
}
],
"practiceLocations": [
{
"address_1": "911 Bypass Rd Bldg A",
"address_purpose": "LOCATION",
"city": "Pikeville",
"state": "KY",
"postal_code": "415011689",
"country_code": "US",
"telephone_number": "606-430-2208",
"fax_number": "606-218-7508",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "631 Glenties Drive",
"address_purpose": "LOCATION",
"city": "Smyrna",
"state": "TN",
"postal_code": "37167",
"country_code": "US",
"telephone_number": "615-419-7744",
"fax_number": "615-205-6878",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "KEITH",
"middle_name": "F",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "KY",
"license": "C0223",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "AR",
"license": "E-11140",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TN",
"license": "MD0000035914",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IN",
"license": "01088351A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kwatson@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "550 S Landmark Ave",
"city": "Bloomington",
"state": "IN",
"country_code": "US",
"postal_code": "474033239",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.