Individual provider Active NPI

Bruce Parmer Williams, M.D.

  • Pediatrics Physician
  • Evansville, IN
National Provider Identifier
1174734602
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01025479A Issued in IN
Practice address
4101 Heckel Rd
Evansville, IN 47725-7328
Phone
(812) 479-8411
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01025479A IN Primary

Addresses

Primary practice location

4101 Heckel Rd
Evansville, IN 47725-7328

Mailing address

4101 Heckel Rd
Evansville, IN 47725-7328
Phone (812) 479-8411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc Pediatrics CurrentSince Oct 1, 2008 Accepting new patients
Deaconess Clinic Inc Pediatrics CurrentSince Oct 1, 2008 Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4209 Gateway Blvd
Newburgh, IN 47630
Phone (812) 426-9855

Organizations & group practices 3

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1174734602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 HECKEL RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477257328",
            "telephone_number": "812-479-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 HECKEL RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477257328",
            "telephone_number": "812-479-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRUCE",
        "middle_name": "PARMER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01025479A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.