Active NPI
Tammy G Watts, ANP
- Adult Health Nurse Practitioner
- Columbia, SC
National Provider Identifier
1992745905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 455
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP0642 | Medicaid | SC |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100519000361 | SC | Practitioner - Nurse Practitioner | 8123157898 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alice J. Brooks, MD, PA | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Primary Care Clinic/Center
- Lugoff, SC
- NPI 1093762171
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.