Active NPI
Duane A. Williams, PT, DSC, MA
- Physical Therapist
- Johnson City, TN
National Provider Identifier
1144573114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT0000001193
- Practice address
- 807 University Pkwy
Box 70403
Johnson City, TN 37614-6500 - Phone
- (423) 439-4071
- Fax
- (423) 439-4060
- NPI assigned
- Oct 16, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0000001193 | TN | Primary |
Addresses
Primary practice location
807 University Pkwy
Box 70403
Johnson City, TN 37614-6500
Mailing address
807 University Pkwy
Box 70403
Johnson City, TN 37614-6500
Phone (423) 439-4071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT0000001193 | Other | TN | ST LIC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0000001193 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1144573114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 UNIVERSITY PKWY",
"address_2": "BOX 70403",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376146500",
"telephone_number": "423-439-4071",
"fax_number": "423-439-4060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 UNIVERSITY PKWY",
"address_2": "BOX 70403",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376146500",
"telephone_number": "423-439-4071",
"fax_number": "423-439-4060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DUANE",
"middle_name": "A.",
"credential": "PT, DSC, MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-16",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT0000001193",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ST LIC",
"identifier": "PT0000001193",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.