NPIMap

Individual provider Active NPI

William Christopher Williams, PA-C

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1093814949
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03260 Issued in TX
Practice address
1910 Roseland Blvd
Tyler, TX 75701
Phone
(903) 533-0644
Fax
(903) 533-0441
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 PA03260 TX Primary

Addresses

Primary practice location

1910 Roseland Blvd
Tyler, TX 75701

Mailing address

1910 Roseland Blvd
Tyler, TX 75701
Phone (903) 533-0644

Other identifiers 1

IdentifierTypeStateIssuer
8N7865OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000226 TX Practitioner - Physician Assistant 8123076726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Internal Medicine Associates, P.aGroup PAC ID 3476541731, 14 clinicians

Practice addresses (Care Compare)

1910 Roseland Blvd
Tyler, TX 75701-4246
Phone (903) 533-0644

Hospital & facility affiliations

  • Ut Health East Texas Home Health Services Home health agency, Athens, TX, CCN 677586
  • Ut Health East Texas Home Health Services Home health agency, Pittsburg, TX, CCN 677037
  • Choice Homecare Home health agency, Tyler, TX, CCN 458261
  • Paradigm Homecare Home health agency, Tyler, TX, CCN 457833
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA03260TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Medical Center Healthcare Associates Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADCFBA/Endpoint/ADCFBA
  • Direct secure messaging: chris.williams@tima.eclinicaldirectplus.com

Organizations & group practices 2

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 7

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1093814949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROSELAND BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-533-0644",
            "fax_number": "903-533-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROSELAND BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-533-0644",
            "fax_number": "903-533-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WILLIAM",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N7865",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.