Individual provider Active NPI

Judith Lynn Williams, M.D.

  • Surgery Physician
  • Lakewood, CO
National Provider Identifier
1114113263
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33022 Issued in CO
Practice address
12610 W Bayaud Ave
#10
Lakewood, CO 80228-2022
Phone
(303) 501-2793
NPI assigned
Sep 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33022 CO Primary

Addresses

Primary practice location

12610 W Bayaud Ave
#10
Lakewood, CO 80228-2022

Mailing address

12610 W Bayaud Ave
#10
Lakewood, CO 80228-2022
Phone (804) 366-5206

Other identifiers 1

IdentifierTypeStateIssuer
01330224MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080919000487 TX Practitioner - General Surgery 9032286828 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Virginia Commonwealth University, School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Chinle Comprehensive Health Care FacilityGroup PAC ID 9436062585, 160 clinicians

Practice addresses (Care Compare)

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

PO Box PH
Chinle, AZ 86503-8000

Hospital & facility affiliations

  • Chinle Comprehensive Health Care Facility Hospital, Chinle, AZ, CCN 030084

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
61.32
Improvement activities
40
Cost
90.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33022COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation CurrentSince Jan 30, 2011 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive CurrentSince Mar 4, 2013 Accepting new patients
Tuba City Regional Health Care Corporation Surgery Current Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Mar 4, 2013 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jul 21, 2008 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jan 30, 2011 Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

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": "1190419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1114113263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12610 W BAYAUD AVE",
            "address_2": "#10",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282022",
            "telephone_number": "804-366-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12610 W BAYAUD AVE",
            "address_2": "#10",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282022",
            "telephone_number": "303-501-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUDITH",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-22",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "33022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01330224",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.