Active NPI
Charles E Williams Jr., PT, CFCE
- Physical Therapist
- Bristol, VA
National Provider Identifier
1215038484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305202736
- Practice address
- 136 Bristol East Rd
Bristol, VA 24202-5500 - Phone
- (276) 591-5484
- Fax
- (276) 591-5477
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305202736 | VA | Primary |
Addresses
Primary practice location
136 Bristol East Rd
Bristol, VA 24202-5500
Mailing address
PO Box 16937
Bristol, VA 24209-6937
Phone (276) 591-5484
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193651 | Other | VA | ANTHEM BLUE CROSS |
| 4092102 | Other | TN | BLUE CROSS BLUE SHIELD |
| 7263754 | Other | VA | AETNA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305202736 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Function Better Therapy Services | Physical Therapist | Current | Accepting new patients |
Locations
295 Bristol East Rd
Bristol, VA 24202
Phone (276) 591-5484
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Bristol, VA
- NPI 1790881415
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1215038484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16937",
"city": "BRISTOL",
"state": "VA",
"postal_code": "242096937",
"telephone_number": "276-591-5484",
"fax_number": "276-591-5477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 BRISTOL EAST RD",
"city": "BRISTOL",
"state": "VA",
"postal_code": "242025500",
"telephone_number": "276-591-5484",
"fax_number": "276-591-5477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CHARLES",
"middle_name": "E",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PT, CFCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305202736",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "193651",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4092102",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7263754",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bristol, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.