Individual provider Active NPI

Jacob Williams

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1013602002
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74473 Issued in TN
Practice address
1924 Alcoa Hwy # U-67
Knoxville, TN 37920-1511
Phone
(865) 305-9350
NPI assigned
Apr 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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 74473 TN Primary

Addresses

Primary practice location

1924 Alcoa Hwy # U-67
Knoxville, TN 37920-1511

Mailing address

1924 Alcoa Hwy # U-67
Knoxville, TN 37920-1511

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
I20230831004670 TN Order and Referring Only - Family PracticePractitioner - Family Practice 1951764315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74473TNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1013602002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U-67",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U-67",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-06",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "74473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.