Individual provider Active NPI

Gerald Eugene Williams, D.O.

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1124271002
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO151083 Issued in OR
Practice address
2020 Capitol St NE
Salem, OR 97301-0644
Phone
(503) 399-2424
Fax
(503) 375-7429
NPI assigned
Oct 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO151083 OR Primary

Addresses

Primary practice location

2020 Capitol St NE
Salem, OR 97301-0644

Mailing address

PO Box 8100
Salem, OR 97303-0900
Phone (503) 399-2424

Other identifiers 1

IdentifierTypeStateIssuer
500625304MedicaidOR

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
I20101019001291 OR Practitioner - Family Practice 0042403362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

2531 Boone Rd SE
Salem, OR 97306-9675
Phone (503) 399-2424

Hospital & facility affiliations

  • First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308
  • Salem Hospital Hospital, Salem, OR, CCN 380051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO151083ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC CurrentSince Jul 15, 2010 Accepting new patients

Locations

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

Interoperability endpoints

  • Direct secure messaging: gwilliams39230@salemclinic.gardenplot.direct-ci.com

Organizations & group practices 1

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 3

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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1124271002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973030900",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010644",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GERALD",
        "middle_name": "EUGENE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-23",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO151083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500625304",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.