Christopher Deshawn Watson, M.D.
Individual provider Active NPI Family Medicine Physician · Jacksonville, FL
NPI 1972990141 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1972990141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME136380 (FL)
- Practice address
- 2627 Riverside Ave
Jacksonville, FL 32204-4717 - Phone
- (904) 308-7372
- Fax
- (904) 308-2998
- NPI assigned
- Apr 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 11
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Meharry Medical College School of Medicine, 2015
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Agape Community Health Center, Inc.
St Vincents Medical Center Inc
Practice addresses (Care Compare)
120 King St
Jacksonville, FL 32204-2410
Phone 90476049042117
2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone (904) 308-7372
Hospital & facility affiliations
- Ascension St Vincent'S Riverside
- Ascension St Vincent'S Southside
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181128002949 | FL | Practitioner - Family Practice | 2163736117 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Community Health Center, Inc | Current |
Accepting new patients | |
| Tallahassee Memorial Healthcare Inc | Current | Accepting new patients | |
| Tallahassee Memorial Healthcare Inc | Family Medicine | Current |
Accepting new patients |
| Agape Community Health Center, Inc. | Current | Accepting new patients | |
| St Vincents Medical Center Inc | Current |
Accepting new patients | |
| St Vincents Medical Center Inc | Current |
Accepting new patients | |
| Tallahassee Memorial Healthcare Inc | Family Medicine | Current |
Accepting new patients |
| Agape Community Health Center, Inc. | Past | Accepting new patients | |
| Agape Community Health Center, Inc | Past | Accepting new patients |
Locations
6024 Merrill Rd
Jacksonville, FL 32277
Phone (904) 723-5422
2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372
5460 Blanding Blvd
Jacksonville, FL 32244
Phone (904) 800-6347
3900 University Blvd S
Jacksonville, FL 32216
Phone (904) 222-6656
3101 University Blvd S
Ste 200
Jacksonville, FL 32216
Phone (904) 717-9625
1680 Dunn Ave
Ste 35
Jacksonville, FL 32218
Phone (904) 714-9053
3101 University Blvd S
Ste 200207
Jacksonville, FL 32216
Phone (970) 760-4904
1680 Dunn Ave
Ste 3437
Jacksonville, FL 32218
Phone (904) 760-4964
120 King St
Jacksonville, FL 32204
Phone (904) 800-6347
1680 Dunn Ave
Ste 38
Jacksonville, FL 32218
Phone (904) 760-4905
1301 Hodges Dr
Tallahassee, FL 32308
Phone (850) 431-5430
Interoperability endpoints
- christopher.watson.1@8967.direct.athenahealth.com
- christopher.watson.1@12891.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01077666A | IN | |
| Obstetrics Physician | 207VX0000X | 82699 | GA | |
| Family Medicine Physician | 207Q00000X | ME136380 | FL | Yes |
Addresses
Primary practice location
2627 Riverside Ave
Jacksonville, FL 32204-4717
Mailing address
4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6017
Other practice location 1
233 N Houston Rd Ste 140E
Warner Robins, GA 31093
Phone (478) 975-6880
Other practice location 2
1520 N Senate Ave
Indianapolis, IN 46202-2213
Phone (317) 962-8893
Other practice location 3
233 N Houston Rd Ste 140E
Warner Robins, GA 31093
Phone (478) 975-6880
Other providers in Jacksonville, FL
- Avery Grace Watson
- Bethany Watson
- Betty Lou Watson
- Carrie Watson
- Cecilia Watson
- David Watson
- Emma Delores Watson
- Hangyu Shen Watson
- Holly Watson
- James Alden Watson
All providers in Jacksonville, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.