Active NPI
David Bruce Williams, M.D.
- Internal Medicine Physician
- Fort Campbell, KY
National Provider Identifier
1154441954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD13164
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (270) 798-4677
- Fax
- (931) 645-4705
- NPI assigned
- Mar 29, 2007
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD13164 | TN | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (931) 302-7620
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 621829635 | Other | TN | TAX IDENTIFICATION NO |
| 3858266 | Medicaid | TN | |
| 3155576 | Other | TN | BCBS TN PROVIDER NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190830000568 | TN | Order and Referring Only - Internal Medicine | 7911173166 | |
| I20220127002978 | KY | Order and Referring Only - Internal Medicine | 7911173166 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Tennessee, HSC, College of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Physical Therapy Holdings Inc
Practice addresses (Care Compare)
980 Professional Park Dr
Suite D
Clarksville, TN 37040-5251
Phone (931) 221-9967
Hospital & facility affiliations
- Suncrest Home Health
- Vanderbilt Clarksville Hospital
- Jennie Stuart Medical Center
- Vanderbilt University Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 62 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centennial Heart LLC | Internal Medicine | Past | Accepting new patients |
| Covenant Family Practice, PC | 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.
-
- Family Medicine Physician
- Clarksville, TN
- NPI 1225073166
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hopkinsville, KY
- NPI 1235139312
-
- General Acute Care Hospital
- Clarksville, TN
- NPI 1285689794
-
- Home Health Agency
- Clarksville, TN
- NPI 1427003607
-
- General Acute Care Hospital
- Nashville, TN
- NPI 1396882205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743033600000",
"number": "1154441954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "931-302-7620",
"fax_number": "270-798-8112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "270-798-4677",
"fax_number": "931-645-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DAVID",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2025-03-27",
"certification_date": "2025-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "MD13164",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NO",
"identifier": "621829635",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3858266",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TN PROVIDER NO",
"identifier": "3155576",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.