Koran Watson Haven of Health LLC
NPI 1104401322ActiveOrganization· Dietitian, Registered· Philadelphia, PA
Dietitian, Registered in Philadelphia, Pennsylvania, registered in NPPES in March 2021. The authorized official on file is Koran Watson, RDN LDN, Owner/ Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104401322 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 10, 2021 |
| Last updated in NPPES | Aug 12, 2022 |
| Certified by provider | Aug 12, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (PA) |
|---|
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