Tyler Daniel Williams, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2023-02680 Issued in NC

Practice address

6800 Glenwood Ave
Raleigh, NC 27612-7133

Phone

(919) 235-1939

Fax

(919) 235-1344

NPI assigned

Mar 26, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Philadelphia Col of Osteo Med, Sewanee, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Raleigh, NC
  • NPI 1063096345
  NPD
• Wake Specialty Physicians LLC

  • Pediatrics Physician
  • Fuquay Varina, NC
  • NPI 1578334892
  NPD
• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Morrisville, NC
  • NPI 1174491138
  NPD (past)

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

• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1154958353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "877-498-4490",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127133",
            "telephone_number": "919-235-1939",
            "fax_number": "919-235-1344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "713-790-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYLER",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-02680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomas Jamar Williams
• Traneka Williams
• Travis Edward Williams, LCMHC
• Tressa Jacinda Williams, COTA/L
• Tyana A'Rie Williams, BS
• Valarie Mashea' Williams, LMBT
• Virginia Elizabeth Williams, M.ED, ATC-L
• Whitney Williams
• Williamson Medical Distribution Inc.
• Adam Davis Williamson, RD

• Family Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.

Verify at the official NPI Registry.