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MISS KORAN BIANCA WATSON
NPI 1174162572
Dietitian, Registered in Philadelphia, PA

Active since January 02, 2020
21 S 11TH ST, PHILADELPHIA, PA 19107(267) 209-3245(267) 907-8591 Get Directions Write a Review

NPPES record last updated: August 12, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 12, 2022, Dec 20, 2021, Mar 16, 2021 and 2 more (5 updates tracked since 2020).

About Miss Koran Bianca Watson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS KORAN BIANCA WATSON (NPI 1174162572) is an individual dietitian, registered in Philadelphia, Pennsylvania, licensed in Pennsylvania (DN0006020) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1174162572
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMISS KORAN BIANCA WATSON
Location Address21 S 11TH STPhiladelphia, PA 19107-4223
Mailing Address21 S 11th StPhiladelphia, PA 19107-4223 · (267) 209-3245 · Fax (267) 907-8591
Phone(267) 209-3245
Fax(267) 907-8591
Sole ProprietorNo
Enumeration DateJanuary 2, 2020
Last NPPES UpdateAugust 12, 20225 updates tracked since enumeration
NPPES CertifiedAugust 12, 2022
✔ NPI 1174162572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Licenses✔ Licensed in PA · DN0006020✔ Licensed in PA · DN006020
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
21 S 11TH ST, Philadelphia, PA 19107
Open in Google Maps ↗

Other Identifiers 1

OtherDN006020PA · Pa Nursing Broad

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Koran Bianca Watson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Koran Watson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Koran Watson Haven Of Health LLC
Same address
Dietitian, Registered
21 S 11TH ST
Philadelphia, PA 19107
  • Reassigned Medicare billing, Pennsylvania enrollment
NPI 1104401322 (267) 209-3245

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAMILITY HOME CARE SOLUTIONS
In Home Supportive Care
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 578-1507
KORAN WATSON HAVEN OF HEALTH LLC
Dietitian, Registered
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (267) 209-3245
HANNA LEE ATR-P
Art Therapist
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (267) 603-7126
FAITH MEASURES NETWORK, INC
In Home Supportive Care
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 268-6250
RELEBOHILE LEBO LETSIE
Doula
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (267) 225-3858
KALAHARI BABY CO.
Doula
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (267) 225-3858
ALEXANDER RYN NICOLAS
Social Worker
21 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (267) 603-7126

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Koran Watson's NPI number?

The NPI number for Koran Watson is 1174162572. It was assigned to this individual provider in the NPPES registry on January 2, 2020.

Where is Koran Watson located?

Koran Watson practices at 21 S 11th St, Philadelphia, PA 19107. The listed phone number is (267) 209-3245.

What is Koran Watson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Koran Watson enrolled in Medicare?

Yes. Koran Watson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Koran Watson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Koran Watson reassigns Medicare benefits to Koran Watson Haven Of Health LLC (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Koran Watson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Koran Watson was last updated on August 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.