Active NPI
Douglas J Watkins, M.D.
- Geriatric Medicine (Family Medicine) Physician
- Saint Cloud, MN
National Provider Identifier
1992795652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 31999
- Practice address
- 1900 Centracare Cir
Saint Cloud, MN 56303-5000 - Phone
- (320) 229-4917
- Fax
- (320) 229-5181
- NPI assigned
- Oct 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31999 | MN | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 31999 | MN | Primary |
Addresses
Primary practice location
1900 Centracare Cir
Saint Cloud, MN 56303-5000
Mailing address
3366 Oakdale Avenue No
#315 North Clinic PA
Robbinsdale, MN 55422-2948
Phone (763) 587-7900
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0707716 | Other | MEDICA HEALTH PLANS | |
| COMP | Other | CHAMPUS | |
| 2114087 | Other | FIRST HEALTH PLAN | |
| 761592200 | Other | MEDICAL ASSISTANCE (MA) | |
| HP22747 | Other | HEALTH PARTNERS | |
| COMP | Other | ONE HEALTH PLAN/GREAT WST | |
| 110935 | Other | U-CARE | |
| 601023 | Other | ARAZ GROUP/AMERICAS PPO | |
| COMP | Other | MMSI | |
| 080073015 | Other | RAILROAD MEDICARE | |
| 86D81WA | Other | BLUE CROSS BLUE SHIELD | |
| 438598 | Other | PREFERRED ONE | |
| 761592200 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31999 | MN | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pierz Villa, Inc. | Past | Accepting new patients |
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.
-
- Skilled Nursing Facility
- Pierz, MN
- NPI 1376656512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1992795652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3366 OAKDALE AVENUE NO",
"address_2": "#315 NORTH CLINIC PA",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222948",
"telephone_number": "763-587-7900",
"fax_number": "763-587-7989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 CENTRACARE CIR",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563035000",
"telephone_number": "320-229-4917",
"fax_number": "320-229-5181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "DOUGLAS",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-25",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "31999",
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "MN",
"license": "31999",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLANS",
"identifier": "0707716",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "COMP",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH PLAN",
"identifier": "2114087",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE (MA)",
"identifier": "761592200",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP22747",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH PLAN/GREAT WST",
"identifier": "COMP",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U-CARE",
"identifier": "110935",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ GROUP/AMERICAS PPO",
"identifier": "601023",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMSI",
"identifier": "COMP",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080073015",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "86D81WA",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "438598",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "761592200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.