Active NPI
Susan Jean Williams, MD
- Family Medicine Physician
- Winston Salem, NC
National Provider Identifier
1164406120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25541
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2255
- NPI assigned
- Dec 2, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25541 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5417452 | Other | AETNA | |
| 2115900A | Other | MEDICARE | |
| 32766 | Other | MEDCOST | |
| 5770297 | Medicaid | VA | |
| 8987955 | Medicaid | NC | |
| 16872 | Other | PARTNERS | |
| 80183944 | Other | RR MEDICARE | |
| 87955 | Other | BCBS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25541 | NC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1164406120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SUSAN",
"middle_name": "JEAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-02",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "25541",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5417452",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "2115900A",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "32766",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5770297",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8987955",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "16872",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "80183944",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "87955",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.