Active NPI
James R Williams, MD
- Body Imaging Physician
- Mount Vernon, MO
National Provider Identifier
1093782211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- R6373
- Practice address
- 600 N Main
Mount Vernon, MO 65712-1004 - Phone
- (417) 466-3711
- Fax
- (417) 461-5765
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | R6373 | MO | Primary |
Addresses
Primary practice location
600 N Main
Mount Vernon, MO 65712-1004
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 884-3019
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200396711 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6373 | MO | MD | Body Imaging Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1093782211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-884-3019",
"fax_number": "573-884-4517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N MAIN",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657121004",
"telephone_number": "417-466-3711",
"fax_number": "417-461-5765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JAMES",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "MO",
"license": "R6373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200396711",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.