Individual provider Active NPI

Wesley Williams, M.D.

  • Family Medicine Physician
  • Midwest City, OK
National Provider Identifier
1205802105
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21511 Issued in OK
Practice address
1636 Midtown PL
Midwest City, OK 73130-6347
Phone
(405) 869-7700
NPI assigned
Feb 28, 2006
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21511 OK Primary

Addresses

Primary practice location

1636 Midtown PL
Midwest City, OK 73130-6347

Mailing address

PO Box 659506
Section 4142
San Antonio, TX 78265-9506
Phone (405) 869-7700

Other identifiers 1

IdentifierTypeStateIssuer
100103230AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505001035 OK Practitioner - Family Practice 8921177718 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Health, PC Family Medicine CurrentSince Aug 1, 2000 Accepting new patients
National Family Medical Associates, LLC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

225 Lilac Dr
Ste 200
Edmond, OK 73034
Phone (405) 330-7000

1636 Midtown Pl
Oklahoma City, OK 73130
Phone (405) 869-7700

1720 NE 23rd St
Oklahoma City, OK 73111
Phone (405) 280-5550

600 National Ave
Oklahoma City, OK 73110
Phone (405) 869-7700

7912 E 31st Ct
Ste 220
Tulsa, OK 74145
Phone (352) 572-5457

Interoperability endpoints

  • Direct secure messaging: ms_wwilli78@landmarkhealth-direct.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1205802105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 659506",
            "address_2": "SECTION 4142",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782659506",
            "telephone_number": "405-869-7700",
            "fax_number": "405-869-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 MIDTOWN PL",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306347",
            "telephone_number": "405-869-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "21511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100103230A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.