Individual provider Active NPI

Seth M Williams, M.D.

  • Pediatrics Physician
  • Corvallis, OR
National Provider Identifier
1093038986
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD158582 Issued in OR
Practice address
777 NW 9TH St Ste 320
Corvallis, OR 97330-6169
Phone
(541) 768-4900
NPI assigned
Mar 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD158582 OR Primary

Addresses

Primary practice location

777 NW 9TH St Ste 320
Corvallis, OR 97330-6169

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

2801 N. Gantenbein Legacy Emanuel Medical Center
Randall Children's Hospital
Portland, OR 97227
Phone (503) 415-5403

Other identifiers 1

IdentifierTypeStateIssuer
MD158582OtherOROREGON LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swilliams229211@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20121126000514 OR Practitioner - Pediatric MedicinePractitioner - Hospitalist 1658522552 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD158582ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County Current Accepting new patients
Mulnomah County CurrentSince Apr 1, 2016 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jan 1, 2022 Accepting new patients
McKenzie Physician Services LLC CurrentSince Oct 24, 2012 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jan 1, 2022 Accepting new patients
Multnomah County CurrentSince Apr 1, 2016 Accepting new patients

Locations

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

777 NW 9th St
Ste 320
Corvallis, OR 97330
Phone (541) 768-1840

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

5329 NE Mlk Jr Blvd
Portland, OR 97211
Phone (503) 988-3821

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1093038986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NW 9TH ST STE 320",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306169",
            "telephone_number": "541-768-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 N. Gantenbein Legacy Emanuel Medical Center",
            "address_2": "Randall Children's Hospital",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97227",
            "country_code": "US",
            "telephone_number": "503-415-5403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-05",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD158582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE NUMBER",
            "identifier": "MD158582",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swilliams229211@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "777 NW 9th St Ste 320",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973306169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.