Individual provider Active NPI

Ryan Cole Williams, PA.C

  • Physician Assistant
  • Big Spring, TX
National Provider Identifier
1073612164
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04528 Issued in TX
Practice address
2503 S Gregg St
Unit C
Big Spring, TX 79720-2549
Phone
(325) 658-1511
Fax
(325) 481-2166
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04528 TX Primary

Addresses

Primary practice location

2503 S Gregg St
Unit C
Big Spring, TX 79720-2549

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 1

IdentifierTypeStateIssuer
PA04528OtherTXLICENSE

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070427000247 TX Practitioner - Physician Assistant 4981700580 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
Big Bend Medical GroupGroup PAC ID 2163326281, 46 clinicians
Dora Roberts Rehabilitation CenterGroup PAC ID 0941285498, 114 clinicians

Practice addresses (Care Compare)

1501 W 11TH PL
Big Spring, TX 79720-4119
Phone (432) 714-4600

1501 W 11TH PL
Big Spring, TX 79720-4121

1501 W 11TH PL
Big Spring, TX 79720-4122

1501 W 11TH Place
Big Spring, TX 79720-4121

1501 W 11TH Place
Big Spring, TX 79720-4122

1608 W FM
Big Spring, TX 79720-4113

1608 W FM 700
Big Spring, TX 79720-4113

306 W 3Rd St
Big Spring, TX 79720-2429
Phone (432) 267-3806

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Big Bend Medical Group CurrentSince Oct 16, 2024 Accepting new patients

Locations

1501 W 11th Pl
Ste 110
Big Spring, TX 79720
Phone (432) 268-4522

1608 W FM 700
Ste C
Big Spring, TX 79720
Phone (432) 263-7700

910 S Main St
Big Spring, TX 79720
Phone (423) 714-4650

1501 W 11th Pl
Ste 305
Big Spring, TX 79720
Phone (432) 268-5310

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

7101 Eastridge Rd
Odessa, TX 79765
Phone (432) 550-0048

Interoperability endpoints

  • Direct secure messaging: rwilliams8675@shannonhealth.direct-ci.com
  • Direct secure messaging: ryan.williams.5@1603.direct.athenahealth.com

Organizations & group practices 7

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 3

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1073612164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 S GREGG ST",
            "address_2": "UNIT C",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797202549",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RYAN",
        "middle_name": "COLE",
        "credential": "PA.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA04528",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Spring, TX

Sources for this page

Verify at the official NPI Registry.