John Wesley Williams, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

P8629 Issued in TX

Practice address

1602 Rock Prairie Rd Ste 3000
College Station, TX 77845-5989

Phone

(979) 696-3171

NPI assigned

Sep 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

General Surgery

Education

University of Texas Medical Branch at Galveston, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.williams.2@8042.direct.athenahealth.com

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.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984

  Surgery

  Medicare reassignment NPD
• Privia Medical Group Gulf Coast PLLC

  dba Express Pain and Urgent Care

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • College Station, TX
  • NPI 1881656247
  NPD

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

• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1023118502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE. 3000",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "77845",
            "telephone_number": "979-696-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 3000",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455989",
            "telephone_number": "979-696-3171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7950 Martin Loop",
            "address_purpose": "LOCATION",
            "city": "Fort Benning",
            "state": "GA",
            "postal_code": "319055647",
            "country_code": "US",
            "telephone_number": "706-554-3582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "052240",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P8629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332647202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "8LJ359",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Alan Williams, D.D.S
• Andrew James Williams, PH.D.
• Avery Claire Williams, MD
• Brian Keith Williams, PH.D.
• Jeannie Louise Williams, D.D.S.
• Kelsey Williams, D.D.S
• Lacresha Marshae Williams, M.S., LCDC
• Odette Grace Williams, M.D.
• Shanna Williams, D.D.S.
• Steven Williams, D.D.S.

• Surgery Physician in College Station, TX
• Providers in College Station, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.