Individual provider Active NPI

Tammy G Watts, ANP

  • Adult Health Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1992745905
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
455 Issued in SC
Practice address
3710 Landmark Dr
Ste 114
Columbia, SC 29204-4034
Phone
(803) 788-5916
Fax
(803) 788-9564
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 455 SC Primary

Addresses

Primary practice location

3710 Landmark Dr
Ste 114
Columbia, SC 29204-4034

Mailing address

3710 Landmark Dr
Ste 114
Columbia, SC 29204-4034
Phone (803) 851-5966

Other identifiers 1

IdentifierTypeStateIssuer
NP0642MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100519000361 SC Practitioner - Nurse Practitioner 8123157898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alice J. Brooks, MD, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tammywatts@hc-sc.direct.office.nextgen.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1992745905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 LANDMARK DR",
            "address_2": "STE 114",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044034",
            "telephone_number": "803-851-5966",
            "fax_number": "803-828-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 LANDMARK DR",
            "address_2": "STE 114",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044034",
            "telephone_number": "803-788-5916",
            "fax_number": "803-788-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "TAMMY",
        "middle_name": "G",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0642",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.