NPIMap

Individual provider Active NPI

Russell Warren Williams, M.D.

  • Family Medicine Physician
  • Stafford, VA
National Provider Identifier
1144226879
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101030314 Issued in VA
Practice address
422 Garrisonville Rd
Ste 111
Stafford, VA 22554-1573
Phone
(540) 657-9441
Fax
(540) 657-4366
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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 0101030314 VA Primary

Addresses

Primary practice location

422 Garrisonville Rd
Ste 111
Stafford, VA 22554-1573

Mailing address

PO Box 249
Garrisonville, VA 22463-0249
Phone (540) 657-9441

Other identifiers 1

IdentifierTypeStateIssuer
010042941MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050126000830 VA Practitioner - Family Practice 2062462153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

422 Garrisonville Rd
Suite 111
Stafford, VA 22554-1573
Phone (540) 657-9441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101030314VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stafford Primary Care Associates, Inc. CurrentSince Sep 1, 2003 Accepting new patients
Stafford Urgent Care, Inc. CurrentSince Sep 1, 2003 Accepting new patients
Colonial Beach Medical Center PastSince Mar 1, 2007 Accepting new patients

Locations

413 Chatham Square Office Park
Fredericksburg, VA 22405
Phone (540) 300-6182

422 Garrisonville Rd
Ste 111
Stafford, VA 22554
Phone (540) 657-9441

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1144226879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "GARRISONVILLE",
            "state": "VA",
            "postal_code": "224630249",
            "telephone_number": "540-657-9441",
            "fax_number": "540-657-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 GARRISONVILLE RD",
            "address_2": "STE 111",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541573",
            "telephone_number": "540-657-9441",
            "fax_number": "540-657-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RUSSELL",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101030314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010042941",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.