Active NPI
Berkley Leo Williams, PA-C
- Medical Physician Assistant
- Manassas, VA
National Provider Identifier
1124319801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110840786
- Practice address
- 8708 Sudley Rd
Manassas, VA 20110-4405 - Phone
- (703) 530-1226
- Fax
- (703) 530-1228
- NPI assigned
- Apr 28, 2011
- Last updated
- Apr 28, 2011
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0110840786 | VA | Primary |
Addresses
Primary practice location
8708 Sudley Rd
Manassas, VA 20110-4405
Mailing address
8708 Sudley Rd
Manassas, VA 20110-4405
Phone (703) 530-1226
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110840786 | VA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergicare Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303948800000",
"number": "1124319801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8708 SUDLEY RD",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104405",
"telephone_number": "703-530-1226",
"fax_number": "703-530-1228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8708 SUDLEY RD",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104405",
"telephone_number": "703-530-1226",
"fax_number": "703-530-1228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "BERKLEY",
"middle_name": "LEO",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-28",
"last_updated": "2011-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110840786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.