DR. NICHOLAS WATTERS (NPI# 1063468817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063468817 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS WATTERS |
| Credential | PSYD |
| Practice Address |
240 W Dixie Suite 5-b Elizabethtown KY 42701-1575 |
| Mailing Address |
Po Box 6278 Elizabethtown KY 42702-6278 |
| Practice Telephone | 2704014107 |
| Practice Fax Number | 2702090872 |
| Mailing Telephone | 2704014107 |
| Mailing Fax Number | 2702090872 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1492 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100266120 | 05 | |
| CAQH | 11574941 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114400918 | Nicholas Gregory Watters | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-09-08 |
| Street Address |
240 W DIXIE, SUITE 5-B |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-1575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922518216 | Nathaniel Ross Rhoad | Psychologist | 422 Cloverleaf Rd, Elizabethtown, PA 17022-9320 | 2017-10-02 |
| 1669746202 | Franklin P. Ryan | Psychologist | 44 S Market St, Elizabethtown, PA 17022-2307 | 2012-02-29 |
| 1922151141 | Laura Margaret Soden | Psychologist | 208 Water Street, Suite 21, Elizabethtown, NY 12932-0356 | 2007-01-19 |
| 1518018019 | Phyllis Ann Perna | Psychologist | 107 Hand Avenue, Elizabethtown, NY 12932 | 2007-01-13 |
| 1801846647 | Jon Russell Urey | Psychologist | 2608 Ring Rd, Suite 102, Elizabethtown, KY 42701-7945 | 2006-05-11 |
| 1912961046 | Donald Edward Wooldridge | Psychologist | 2608 Ring Road, Suite 102, Elizabethtown, KY 42701 | 2006-04-14 |
| 1710941307 | Rollin S. Rhodes | Psychologist | 915 Memorial Ct, Elizabethtown, KY 42701-2525 | 2006-04-12 |
| 1538143326 | John Joseph Hannifan | Psychologist | 308 N Mulberry St, Elizabethtown, KY 42701-1846 | 2005-12-05 |
| 1801136361 | Nick Watters, Psyd Plc | Psychologist | 240 W Dixie Ave, Suite 5-b, Elizabethtown, KY 42701-1586 | 2013-02-20 |
| 1164672473 | Lisa Nelson | Psychologist | 890 Rineyville Rd, Elizabethtown, KY 42701-8927 | 2008-09-23 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on DR. NICHOLAS WATTERS.
| 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.