Active NPI
John Williams, M.D.
- Health Maintenance Organization
- Pacific, MO
National Provider Identifier
1063684868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- 36324
- Practice address
- 18701 Old Highway 66
Pacific, MO 63069-3526 - Phone
- (636) 257-3322
- Fax
- (636) 257-8026
- NPI assigned
- Apr 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | 36324 | MO | Primary |
Addresses
Primary practice location
18701 Old Highway 66
Pacific, MO 63069-3526
Mailing address
18701 Old Highway 66
Pacific, MO 63069
Phone (636) 257-3322
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36324 | MO | MD | Health Maintenance Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1063684868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18701 OLD HIGHWAY 66",
"city": "PACIFIC",
"state": "MO",
"postal_code": "63069",
"telephone_number": "636-257-3322",
"fax_number": "636-257-8026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18701 OLD HIGHWAY 66",
"city": "PACIFIC",
"state": "MO",
"postal_code": "630693526",
"telephone_number": "636-257-3322",
"fax_number": "636-257-8026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-01",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "MO",
"license": "36324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacific, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.