Individual provider Active NPI

James R Williams, MD

  • Body Imaging Physician
  • Mount Vernon, MO
National Provider Identifier
1093782211
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
R6373 Issued in MO
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

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200396711MedicaidMO

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

LicenseStateTypeSpecialty
R6373MOMDBody 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.

Verify at the official NPI Registry.