Active NPI
David A Williamson, M.D.
- Diagnostic Radiology Physician
- Jackson, MI
National Provider Identifier
1013918127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301052819
- Practice address
- 205 N East Ave
Imaging Department
Jackson, MI 49201-1753 - Phone
- (517) 783-2612
- Fax
- (517) 783-5991
- NPI assigned
- Aug 10, 2005
- Last updated
- Jan 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4301052819 | MI | Primary |
Addresses
Primary practice location
205 N East Ave
Imaging Department
Jackson, MI 49201-1753
Mailing address
2800 Spring Arbor Rd Ste 102
PO Box 905
Jackson, MI 49203-3895
Phone (517) 783-2612
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4301052819 | Other | MI | STATE OF MICHIGAN MEDICAL LICENSE |
| 300020176 | Other | RAILROAD MEDICARE | |
| 3103801401 | Other | MI | BCBS OF MICHIGAN |
| 1915052 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- dwilliamson451749@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1013918127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 SPRING ARBOR RD STE 102",
"address_2": "PO BOX 905",
"city": "JACKSON",
"state": "MI",
"postal_code": "492033895",
"telephone_number": "517-783-2612",
"fax_number": "517-783-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"address_2": "IMAGING DEPARTMENT",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-783-2612",
"fax_number": "517-783-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "DAVID",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301052819",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN MEDICAL LICENSE",
"identifier": "4301052819",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300020176",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MICHIGAN",
"identifier": "3103801401",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1915052",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.