Active NPI
John P Williams, D.O.
- Internal Medicine Physician
- Willits, CA
National Provider Identifier
1144220369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 20A6027
- Practice address
- 1712 S Main St
Ste C
Willits, CA 95490-4400 - Phone
- (707) 459-5585
- Fax
- (707) 459-3548
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20A6027 | CA | Primary |
Addresses
Primary practice location
1712 S Main St
Ste C
Willits, CA 95490-4400
Mailing address
1712 S Main St
Ste C
Willits, CA 95490-4400
Phone (707) 459-5585
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX60271 | Medicaid | CA | |
| 020A60270 | Other | CA | BLUE SHIELD PROVIDER # |
| 110228689 | Other | CA | RAILROAD MEDICARE |
| 20A6027 | Other | CA | BLUE CROSS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050718000819 | CA | Practitioner - Internal Medicine | 0941237382 | Practice locations: Willits, CA; Ukiah, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of New England, College of Osteo Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1162 S Dora St
Ukiah, CA 95482-6340
Phone (707) 459-5585
1772 S Main St
Willits, CA 95490-4435
Phone (707) 459-5585
Hospital & facility affiliations
- Silverline Staff Home Health
- Adventist Health Home Care Services
- Adventist Health Howard Memorial
- Adventist Health Ukiah Valley
- Adventist Health Mendocino Coast
- Sutter Lakeside Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 37.26 of 100
- Quality
- 15
- Improvement activities
- 0
- Cost
- 75.93
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 38 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A6027 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Physicians Network | 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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Paradise, CA
- NPI 1134092190
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Fort Bragg, CA
- NPI 1538113725
-
- Home Health Agency
- Fremont, CA
- NPI 1902371446
-
- Critical Access Hospital
- Lakeport, CA
- NPI 1952634008
-
- General Acute Care Hospital
- Ukiah, CA
- NPI 1235120676
-
- Home Health Agency
- Willits, CA
- NPI 1467630764
-
- Critical Access Hospital
- Willits, CA
- NPI 1356339543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545177600000",
"number": "1144220369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 S MAIN ST",
"address_2": "STE C",
"city": "WILLITS",
"state": "CA",
"postal_code": "954904400",
"telephone_number": "707-459-5585",
"fax_number": "707-459-3548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1712 S MAIN ST",
"address_2": "STE C",
"city": "WILLITS",
"state": "CA",
"postal_code": "954904400",
"telephone_number": "707-459-5585",
"fax_number": "707-459-3548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JOHN",
"middle_name": "P",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2018-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "20A6027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX60271",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER #",
"identifier": "020A60270",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110228689",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "20A6027",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willits, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.