NPIMap

Individual provider Active NPI

Vernon Williams, M.D.

  • Surgery Physician
  • Abilene, TX
National Provider Identifier
1003897091
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L3189 Issued in TX
Practice address
1100 N 19TH St
Suite 4D
Abilene, TX 79601-2344
Phone
(325) 676-8555
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L3189 TX Primary

Addresses

Primary practice location

1100 N 19TH St
Suite 4D
Abilene, TX 79601-2344

Mailing address

1100 N 19TH St
Suite 4D
Abilene, TX 79601-2344

Other identifiers 1

IdentifierTypeStateIssuer
149854501MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vernon.williams@direct.myteamcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000334 TX Practitioner - General Surgery 4688867039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kentucky College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9436
Phone (806) 743-2475

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Nov 1, 2011 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Surgery CurrentSince Nov 1, 2011 Accepting new patients
Hendrick Provider Network Surgery Past Accepting new patients
West Kentucky Surgical, Inc Surgery Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

3502 9th St
Ste 130
Lubbock, TX 79415
Phone (806) 743-1188

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Organizations & group practices 6

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 5

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1003897091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N 19TH ST",
            "address_2": "SUITE 4D",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N 19TH ST",
            "address_2": "SUITE 4D",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012344",
            "telephone_number": "325-676-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L3189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149854501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vernon.williams@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.