Individual provider Active NPI

John B Williamson, PHD

  • Clinical Neuropsychologist
  • Gainesville, FL
National Provider Identifier
1215224977
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY8262 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-4004
Phone
(352) 265-0301
NPI assigned
Jul 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY8262 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-4004

Mailing address

PO Box 918025
Orlando, FL 32891-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120113000753 FL Practitioner - Clinical Psychologist 2567639578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 100371
Gainesville, FL 32610-0371

Merit-based Incentive Payment System (MIPS)

Final score
69.27 of 100Reported as group
Quality
95.72
Promoting interoperability
0
Improvement activities
40
Cost
78.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY8262FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Professionals Association Inc CurrentSince Dec 1, 2011 Accepting new patients
Florida Health Professions Association, Inc. CurrentSince Dec 1, 2011 Accepting new patients

Locations

1600 SW Archer Rd
Rm G901
Gainesville, FL 32610
Phone (352) 265-0294

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1215224977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326104004",
            "telephone_number": "352-265-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.