KENNETH LEROY WATTS (NPI# 1790992261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790992261 |
| Entity Type | Individual |
| Full Name | KENNETH LEROY WATTS |
| Other Name | KENNY LEROY WATTS |
| Credential | MD |
| Practice Address |
3020 Saint Johns Blvd Suite F Joplin MO 64804-1564 |
| Mailing Address |
2228 E 8th St Apt B Joplin MO 64801-5367 |
| Practice Telephone | 4177814404 |
| Practice Fax Number | 4177815845 |
| Mailing Telephone | 5804787100 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2013-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 2013032884 | MO | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 25530 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200116470A | 05 |
| Street Address |
3020 SAINT JOHNS BLVD SUITE F |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804-1564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962440552 | Richard A. Wolf | Internal Medicine | 3020 Saint Johns Blvd, Suite A, Joplin, MO 64804-1564 | 2006-06-03 |
| 1942493549 | Toufic Tony Saad | Internal Medicine | 3020 Saint Johns Blvd, Ste B, Joplin, MO 64804-1564 | 2007-08-27 |
| 1740487552 | Danny T Liu | Surgery | 3020 Saint Johns Blvd, Ste F, Joplin, MO 64804-1564 | 2007-06-27 |
| 1386720878 | Catherine Elizabeth Chatal | Plastic Surgery | 3020 Saint Johns Blvd, Suite D, Joplin, MO 64804-1564 | 2006-10-27 |
| 1508807512 | Shawn W Sabapathy | Internal Medicine | 3020 Saint Johns Blvd, Suite A, Joplin, MO 64804-1564 | 2006-06-09 |
| 1891736815 | Thomas B. Moore | Internal Medicine | 3020 Saint Johns Blvd, Ste A, Joplin, MO 64804-1564 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
| Find all providers in zip 64804 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821234717 | Clinton J. Pace Jr. | Surgery | 100 Mercy Way Ste 440, Joplin, MO 64804-4524 | 2008-12-23 |
| 1588631402 | Alan M Buchele | Surgery | 1020 Mcintosh Cir Ste 201, Joplin, MO 64804-3689 | 2006-03-01 |
| 1740487552 | Danny T Liu | Surgery | 3020 Saint Johns Blvd, Ste F, Joplin, MO 64804-1564 | 2007-06-27 |
| 1295945681 | Charles Youngho Ro | Surgery | 100 Mercy Way, Joplin, MO 64804-4524 | 2007-05-23 |
| 1487867602 | David L Baker | Surgery | 3302 Mcintosh Cir, Joplin, MO 64804-3648 | 2007-05-07 |
| 1811039621 | David E Hargroder | Surgery | 2700 Mcclelland Blvd, Suite 108 Bldg A, Joplin, MO 64804-1623 | 2007-02-12 |
| 1487688370 | Brock Carney | Surgery | 1020 Mcintosh Circle, Ste 102, Joplin, MO 64804 | 2006-07-10 |
| 1104850098 | Kurtis Cox | Surgery | 1020 Mcintosh Circle, Ste 102, Joplin, MO 64804 | 2006-07-10 |
| 1932133840 | Robert Willcoxon | Surgery | 1020 Mcintosh Circle, Ste 102, Joplin, MO 64804 | 2006-07-10 |
| 1649202136 | Mitchell S Meier | Surgery | 1020 Mcintosh Circle, Ste 102, Joplin, MO 64804 | 2006-07-07 |
| Find all providers in JOPLIN | ||||
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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.