Individual provider Active NPI

Alan Robertson Williams II, M.D.

  • Emergency Medicine Physician
  • Clackamas, OR
National Provider Identifier
1174700215
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD158945 Issued in OR
Practice address
10180 SE Sunnyside Road
Emergency Department
Clackamas, OR 97015
Phone
(503) 652-2880
NPI assigned
Jan 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD158945 OR Primary

Addresses

Primary practice location

10180 SE Sunnyside Road
Emergency Department
Clackamas, OR 97015

Mailing address

10180 SE Sunnyside Road
Emergency Department
Clackamas, OR 97015
Phone (503) 652-2880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20130116000343 OR Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4183877400 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
96.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients

Locations

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1174700215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE ROAD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-652-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE ROAD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-652-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ALAN",
        "middle_name": "ROBERTSON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD158945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.