Amy Nicole Williamson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

549 Issued in MT

Practice address

417 State St
Webber East Suite 200
Bangor, ME 04401-6630

Phone

(207) 973-6555

Fax

(207) 973-6554

NPI assigned

Dec 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

University of South Alabama College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awilliamson838807@ahs.direct-ci.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.

• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  Medicare reassignment Care Compare group
• Pocatello Health Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
  • NPI 1154089126
  NPD
• Pocatello Hospital LLC

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1760610935
  NPD

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

• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1083896724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "WEBBER EAST SUITE 200",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-973-6555",
            "fax_number": "207-973-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "AMY",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "549",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA1324",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Ann Williams, LCPC
• Lindsay Williams, M.D.
• Martha E Williams, MSW,MS MED
• Michael Williams, R.PH
• Sabrina L Williams, CCC SLP
• Cheryl Willis, PTA
• Susan M Willows, FNP
• Beverly Ann Wilson, RN
• Carolyn Alice Wilson, MD
• Hope Caitlin Wilson, PMHNP-BC

• Physician Assistant in Bangor, ME
• Providers in Bangor, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.