MR. JEROME BRADFIELD WATSON (NPI# 1538162045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538162045 |
| Entity Type | Individual |
| Full Name | MR. JEROME BRADFIELD WATSON |
| Credential | GNP |
| Practice Address |
7209 Goldfinch Rd Texarkana TX 75501-0227 |
| Practice Telephone | 9033348132 |
| Practice Fax Number | 9033348146 |
| Mailing Telephone | 9033348132 |
| Mailing Fax Number | 9033348146 |
| Enumeration Date | 2005-05-30 |
| Last Update Date | 2020-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
605190 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 160262762 | 05 | |
| OK | 100082540A | 05 | |
| AR | RAILROAD MEDICARE | 500004259 | 01 |
| TX | MEDICARE - LEGACY NUMBER | 8D9579 | 01 |
| TX | TX RAILROAD MEDICARE | P00267929 | 01 |
| TX | 029325002 | 05 | |
| AR | 145430758 | 05 | |
| TX | 029325001 | 05 | |
| AR | MEDICARE - LEGACY NUMBER | 5U081 | 01 |
| TX | RAILROAD MEDICARE | 500004259 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861787277 | Jerome Everette Watson Sr. | Marriage & Family Therapist | 12180 Ridgecrest Rd Ste 402a, Victorville, CA 92395-5902 | 2011-06-14 |
| 1336144138 | Jerome Thomas Watson | Physical Medicine & Rehabilitation | 124 Sunset Hill Dr, Statesville, NC 28625-2729 | 2005-06-17 |
| Street Address |
7209 GOLDFINCH RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75501-0227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477793479 | Jerome Watson LLC | Nurse Practitioner | 7209 Goldfinch Rd, Texarkana, TX 75501-0227 | 2009-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598227951 | Shayla Lasonde Williams | Licensed Vocational Nurse | 409 Tracey Ave, Wake Village, TX 75501 | 2019-04-04 |
| 1861900904 | Tiffany Anne Baugus | Nurse Practitioner | 2600 St. Michael Drive, Texarkana, TX 75501 | 2018-01-10 |
| 1104363258 | Brent Willis | Nurse Anesthetist, Certified Registered | 203 La Grange Dr., Texarkana, TX 75501 | 2017-01-27 |
| 1154627644 | Patricia Maree Baker | Counselor | 1001 Texas Blvd., Suite 106, Texarkana, TX 75501 | 2011-02-01 |
| 1730323452 | William Leonard | Occupational Therapy Assistant | 2108 5th Street, Bridgeport, TX 75501 | 2009-04-24 |
| 1700071552 | Roger House Md, Psychiatric Services | Case Management | 2401 Summerhill Rd., Suite A, Texarkana, TX 75501 | 2007-09-13 |
| 1134248271 | Brent Bultemeier Pa | Chiropractor | 3207 New Boston Road, Texarkana, TX 75501 | 2007-03-28 |
| 1346395977 | Sharon E. Moore | Registered Nurse | Youree Drive, Shreveport, LA 75501 | 2007-01-24 |
| 1962553024 | Leary Independent School District | Local Education Agency (LEA) | 9500 W. New Boston Rd, Texarkana, TX 75501 | 2007-01-16 |
| 1780787390 | Christina Michelle Griffin | Physical Therapist | 1315 Walnut, Temple Memorial Rehabiliation Ctr, Texarkana, TX 75501 | 2006-09-07 |
| Find all providers in zip 75501 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1407203425 | Katherine Antoinette Robertson | Nurse Practitioner | 1307 Trinity Blvd, Texarkana, AR 71854-8310 | 2016-05-19 |
| 1295731545 | Amy Leigh Overton-mccoy | Nurse Practitioner | 1307 Trinity Boulevard, Texarkana, AR 71854 | 2005-06-22 |
| 1114534252 | Lansdell Family Clinic Pllc | Nurse Practitioner | 4102 Gibson Ln, Texarkana, TX 75503-1120 | 2020-09-23 |
| 1184929622 | Andrea K Heflin | Nurse Practitioner | 1400 College Dr, Ste 202, Texarkana, TX 75503-3536 | 2011-01-13 |
| 1114151297 | C Ronald Drye | Nurse Practitioner | 2014 Galleria Oaks Dr, Texarkana, TX 75503-4620 | 2009-05-05 |
| 1326061235 | Leasa L Roach | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262570 | Holly Joyce Carlstrand | Nurse Practitioner | 18 Carmel Chase Ct, Manvel, TX 77578-3452 | 2020-10-13 |
| 1700483690 | Amy Calder | Nurse Practitioner | 14441 Memorial Dr Ste 5, Houston, TX 77079-6708 | 2020-10-05 |
| 1104423300 | Donna Ann Ford | Nurse Practitioner | 1605 Turtle Dr, San Angelo, TX 76904-7708 | 2020-10-01 |
| 1497361653 | Alexis Jolivet | Nurse Practitioner | 8706 Shiloh St, Texas City, TX 77591-2327 | 2020-09-22 |
| 1851906960 | Ann Nnenna Ugbeme | Nurse Practitioner | 1601 Lisburn Dr, Mckinney, TX 75071-3357 | 2020-09-15 |
| 1528673233 | Lashika R Meanus | Nurse Practitioner | 10501 Matador Dr, Mckinney, TX 75072-2952 | 2020-09-10 |
| 1700498391 | Raphael Udalor | Nurse Practitioner | 3631 Campfield Ct, Katy, TX 77449-8621 | 2020-08-17 |
| 1326664020 | Tasha Samantha Leonard | Nurse Practitioner | 622 Orlandis Ln, Rosenberg, TX 77469-5084 | 2020-06-19 |
| 1962025171 | Shewana Spencer | Nurse Practitioner | 613 W Bluff St, Woodville, TX 75979-5125 | 2020-05-21 |
| 1992325906 | Emily Natosha Bennett | Nurse Practitioner | 4323 Dragonwick Dr, Houston, TX 77045-3311 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.