NPIMap

Organization Active NPI

Kenneth D Watkins MD

  • Family Medicine Physician
  • Winchester, IN
National Provider Identifier
1972704013
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01028715 Issued in IN
Legal business name
KENNETH D WATKINS MD
Practice address
108 E Hospital Dr
Winchester, IN 47394-2223
Phone
(765) 584-1639
Fax
(765) 584-4711
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Authorized official

Name
Dr. Kenneth D Watkins, MD
Title
Owner
Phone
(765) 584-1639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01028715 IN Primary

Addresses

Primary practice location

108 E Hospital Dr
Winchester, IN 47394-2223

Mailing address

108 E Hospital Dr
Winchester, IN 47394-2223
Phone (765) 584-1639

Other identifiers 3

IdentifierTypeStateIssuer
169670OtherINREGULAR MEDICARE
00000008478OtherINANTHEM
200399280AMedicaidIN

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23643/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1972704013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E HOSPITAL DR",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473942223",
            "telephone_number": "765-584-1639",
            "fax_number": "765-584-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E HOSPITAL DR",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473942223",
            "telephone_number": "765-584-1639",
            "fax_number": "765-584-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH D WATKINS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-584-1639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01028715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGULAR MEDICARE",
            "identifier": "169670",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000008478",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200399280A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.