DR. CHARLES KEVIN WATT (NPI# 1134124324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134124324 |
| Entity Type | Individual |
| Full Name | DR. CHARLES KEVIN WATT |
| Credential | DO |
| Practice Address |
101 S Main St Rogersville MO 65742-9357 |
| Practice Telephone | 4177539404 |
| Practice Fax Number | 4177539137 |
| Mailing Telephone | 4177539404 |
| Mailing Fax Number | 4177539137 |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2011-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
R2D59 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 241858372 | 05 | |
| MO | 1134124324 | 05 | |
| RR MEDICARE | P00003782 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588620918 | Charles G Watt | Family Medicine | 6970 W. Patrick Lane, Suite #140, Las Vegas, NV 89113-0270 | 2006-04-25 |
| Street Address |
101 S MAIN ST |
| City | ROGERSVILLE |
| State | MO |
| Zip Code | 65742-9357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881699072 | Robert W Powers | Internal Medicine | 101 S Main St, Rogersville, MO 65742-9357 | 2005-06-15 |
| 1578941811 | Michele Tyson | Registered Nurse | 101 S Main St, Rogersville, MO 65742-9357 | 2015-05-06 |
| 1841530474 | Cassidy Nichole Giebler | Nurse Practitioner | 101 S Main St, Rogersville, MO 65742-9357 | 2013-02-19 |
| 1497028344 | Jana Lea Scott | Nurse Practitioner | 101 S Main St, Rogersville, MO 65742-9357 | 2012-02-22 |
| 1669744504 | Bonnie Lisa Stark | Nurse Practitioner | 101 S Main St, Rogersville, MO 65742-9357 | 2012-02-08 |
| 1295938934 | Joseph Adam Reighard | Registered Nurse | 101 S Main St, Rogersville, MO 65742-9357 | 2007-06-08 |
| 1073604690 | Patrick Edward Macmillan | Family Medicine | 101 S Main St, Rogersville, MO 65742-9357 | 2006-09-27 |
| 1013013093 | Thomas E Dahlberg | Family Medicine | 101 S Main St, Rogersville, MO 65742-9357 | 2006-09-16 |
| 1467465237 | John H Kaicher | Internal Medicine | 101 S Main St, Rogersville, MO 65742-9357 | 2006-08-14 |
| 1811950637 | Leea D Reed | Family Medicine | 101 S Main St, Rogersville, MO 65742-9357 | 2006-04-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851953103 | Sara L Newhard | Counselor | 3955 S. Farm Road 223, Rogersville, MO 65742 | 2019-07-07 |
| 1235653551 | Madison Marie Parson | Physical Therapy Assistant | 586 Cottonwood Rd., Rogersville, MO 65742 | 2017-07-28 |
| 1548612062 | Jonathan Price | Student in an Organized Health Care Education/Training Program | 5649 South Highway 125, Rogersville, MO 65742 | 2016-07-08 |
| 1366790941 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 175 S. Marshall, Suite G, Rogersville, MO 65742 | 2012-08-29 |
| 1245426436 | Lori Ann Cole | Occupational Therapist | 113 E. Center St., Ozark Therapy Institute, Rogersville, MO 65742 | 2007-09-20 |
| 1942335203 | Sgoh Acquisition Inc | Clinic/Center | 101 South Main, Rogersville, MO 65742 | 2007-02-23 |
| 1922190842 | Bret E Herrman | Chiropractor | 319 S Main, Ste F, Rogersville, MO 65742-0228 | 2006-09-28 |
| 1952804668 | Equi-librium Therapy Center | Clinic/Center | 1148 S Courtney Ln, Rogersville, MO 65742-4501 | 2018-03-09 |
| 1134167331 | Theodore Brooke Nelson | Physical Therapist | 5764 S Farm Road 203, Rogersville, MO 65742-6436 | 2006-06-02 |
| 1598998775 | Nelson Physical Therapy and Rehab, P.C. | Physical Therapist | 5764 S Farm Road 203, Rogersville, MO 65742-6436 | 2009-09-03 |
| Find all providers in zip 65742 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164781035 | Carlyn Molstad Kline | Family Medicine | 17 Stonecrest, St. Joseph, MO 64506-3126 | 2012-05-11 |
| 1730346230 | Ltc Consultants LLC | Family Medicine | 16201 Bluegrass Ct, Belton, MO 64012-3342 | 2008-05-21 |
| 1487853750 | Susan E. Pearson, LLC | Family Medicine | 6209 Midrivers Mall Dr, #317, St Charles, MO 63304-1102 | 2007-07-16 |
| 1356476071 | Thomas M Macdonnell | Family Medicine | 665 State Highway J, Marshfield, MO 65706-8253 | 2007-02-22 |
| 1538232772 | Randall D. Huss | Family Medicine | 910 W 10th St, Rolla, MO 65401-2904 | 2006-11-16 |
| 1750464723 | Nevada Lee | Family Medicine | 6317 Evanston Ave, Raytown, MO 64133-4929 | 2006-10-23 |
| 1447361977 | Richard O Schamp | Family Medicine | 6255 San Bonita Ave, Saint Louis, MO 63105-3210 | 2006-08-31 |
| 1265546923 | Patricia Sue Inman | Family Medicine | 400 Chesterfield Ctr, Suite 400, Chesterfield, MO 63017-4834 | 2006-08-19 |
| 1770546665 | Kerr Healthcare Services LLC | Family Medicine | 11851 Arbor Cir, Rolla, MO 65401-7476 | 2006-04-11 |
| 1831152370 | Jeffery Alan Kerr | Family Medicine | 1000 Gw Ln, Waynesville, MO 65583-2339 | 2006-04-07 |
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| City | ROGERSVILLE |
| Zip Code | 65742 |
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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.