Active NPI
Gene Williamson, COO
- Case Manager/Care Coordinator
- Indianapolis, IN
National Provider Identifier
1144612482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 1681-0-ASO
- Practice address
- 2105 N. Meridian St.
Suite 102
Indianapolis, IN 46202-1358 - Phone
- (317) 926-5463
- Fax
- (317) 926-5498
- NPI assigned
- Feb 24, 2015
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 1681-0-ASO | IN | Primary |
Addresses
Primary practice location
2105 N. Meridian St.
Suite 102
Indianapolis, IN 46202-1358
Mailing address
2105 N. Meridian St.
Suite 102
Indianapolis, IN 46202-1358
Phone (317) 926-5463
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1681-0-ASO | IN | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Outreach Network Services | Past | Accepting new patients | |
| Community Outreach Network Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Indianapolis, IN
- NPI 1659441178
-
- Community/Behavioral Health Agency
- Indianapolis, IN
- NPI 1568867026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424736000000",
"number": "1144612482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 N. MERIDIAN ST.",
"address_2": "SUITE 102",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021358",
"telephone_number": "317-926-5463",
"fax_number": "317-926-5498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 N. MERIDIAN ST.",
"address_2": "SUITE 102",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021358",
"telephone_number": "317-926-5463",
"fax_number": "317-926-5498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "GENE",
"credential": "COO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-24",
"last_updated": "2015-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "IN",
"license": "1681-0-ASO",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.