Individual provider Active NPI

James R Williams, MD

  • Family Medicine Physician
  • Newport, TN
National Provider Identifier
1003884412
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14979 Issued in TN
Practice address
434 4TH St
Ste 301
Newport, TN 37821-3735
Phone
(423) 623-1022
Fax
(423) 625-0327
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14979 TN Primary

Addresses

Primary practice location

434 4TH St
Ste 301
Newport, TN 37821-3735

Mailing address

434 4TH St
Ste 301
Newport, TN 37821-3735
Phone (423) 623-1022

Other identifiers 6

IdentifierTypeStateIssuer
7906926MedicaidNC
0140268OtherUNITED HEALTHCARE
080012097OtherRAILROAD MEDICARE
2003654OtherTNBLUE CROSS
612301OtherJOHN DEERE
3003795MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051114000676 TN Practitioner - Family Practice 4183643745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas W. ConwayGroup PAC ID 5496729105, 3 clinicians

Practice addresses (Care Compare)

434 4TH St
Suite 310
Newport, TN 37821-3735
Phone (423) 623-0640

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14979TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Family Medicine CurrentSince Jun 15, 2008 Accepting new patients
Thomas W. Conway Family Medicine CurrentSince Jul 13, 2010 Accepting new patients

Locations

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

434 4th St
Ste 310
Newport, TN 37821
Phone (423) 623-0640

Networks

  • KY PPO
  • AL HMO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • AL HMO D-SNP
  • MS PPO
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • MS PPO D-SNP
  • MS PPO C-SNP
  • TN PPO C-SNP
  • KY PPO C-SNP
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • TN PPO

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1003884412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 4TH ST",
            "address_2": "STE 301",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213735",
            "telephone_number": "423-623-1022",
            "fax_number": "423-625-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 4TH ST",
            "address_2": "STE 301",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213735",
            "telephone_number": "423-623-1022",
            "fax_number": "423-625-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "14979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7906926",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0140268",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080012097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2003654",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "612301",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003795",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, TN

Sources for this page

Verify at the official NPI Registry.