Christopher Deshawn Watson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME136380 Issued in FL

Practice address

2627 Riverside Ave
Jacksonville, FL 32204-4717

Phone

(904) 308-7372

Fax

(904) 308-2998

NPI assigned

Apr 24, 2015

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Meharry Medical College School of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Agape Community Health Center, Inc.Group PAC ID 3476500695, 7 clinicians

St Vincents Medical Center IncGroup PAC ID 0244144558, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Riverside Hospital, Jacksonville, FL, CCN 100040
• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christopher.watson.1@12891.direct.athenahealth.com
• Direct secure messaging: christopher.watson.1@8967.direct.athenahealth.com

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.

• Agape Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1962867762
  Medicare reassignment Care Compare group NPD
• St Vincents Medical Center Inc

  dba St Vincents Family Medicine Center

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1427005131
  Medicare reassignment Care Compare group NPD
• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment NPD
• Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1326668351
  NPD
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  NPD
• Tallahassee Memorial Healthcare Inc

  dba TMH Physician Partners

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• Tallahassee Memorial Healthcare Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1770647620
  NPD
• Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1376178814
  NPD (past)
• Agape Community Health Center, Inc.

  dba Wesconnett Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1578928826
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent's Medical Center, Inc.

  dba Ascension St Vincent's Riverside

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1972990141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6017",
            "fax_number": "904-450-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044717",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 N Houston Rd Ste 140E",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "31093",
            "country_code": "US",
            "telephone_number": "478-975-6880",
            "fax_number": "478-975-6889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1520 N Senate Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022213",
            "country_code": "US",
            "telephone_number": "317-962-8893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 N Houston Rd Ste 140E",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "31093",
            "country_code": "US",
            "telephone_number": "478-975-6880",
            "fax_number": "478-975-6889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "DESHAWN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01077666A",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "82699",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME136380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery Grace Watson
• Bethany Watson, RN
• Betty Lou Watson, LMHC
• Carrie Watson
• Cecilia Watson, ARNP
• David Watson, DMD
• Emma Delores Watson, NURSE
• Hangyu Shen Watson, M.D.
• Holly Watson
• James Alden Watson, PA

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.

Verify at the official NPI Registry.