Active NPI
Chad Duane Williams, PA-C
- Physician Assistant
- Cannon Falls, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12113
- Practice address
- 32021 County 24 Blvd
Cannon Falls, MN 55009-5003 - Phone
- (507) 263-4221
- NPI assigned
- Dec 10, 2012
- Last updated
- Jul 8, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2204 | OK | |
| Physician Assistant | 363A00000X | 12113 | MN | Primary |
Addresses
Primary practice location
32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Mailing address
32021 Country 24 Blvd
Cannon Falls, MN 55009-5003
Other practice location 1
34 SW 89th St
Oklahoma City, OK 73139-8510
Phone (405) 488-0750
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cwilliams88037@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2204 | OK | MD | Occupational Therapy Assistant |
| 12113 | MN | MD | Physician Assistant |
Practice roles
Locations
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750
701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261
501 State St N
Waseca, MN 56093
Phone (507) 835-1210
Organizations & group practices 16
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.
-
- Multi-Specialty Clinic/Center
- Fairmont, MN
- NPI 1366410862
-
- Multi-Specialty Clinic/Center
- Lake City, MN
- NPI 1164463659
-
- Critical Access Hospital
- Lake City, MN
- NPI 1538113022
-
dba Mayo Clinic Health System-Cannon Falls
- Critical Access Hospital
- Cannon Falls, MN
- NPI 1063435410
-
dba Mayo Clinic Health System-Waseca
- Critical Access Hospital
- Waseca, MN
- NPI 1740256668
-
- Multi-Specialty Clinic/Center
- Saint James, MN
- NPI 1023177730
-
- Critical Access Hospital
- Saint James, MN
- NPI 1639198732
-
dba Critical Access Hospital
- Critical Access Hospital
- Onamia, MN
- NPI 1548212699
-
dba Mayo Clinic Health System - Mankato
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
dba Mayo Clinic Health System-Albert Lea and Austin
- Multi-Specialty Clinic/Center
- Albert Lea, MN
- NPI 1891701637
-
dba Mayo Clinic Health System-Owatonna
- Multi-Specialty Clinic/Center
- Owatonna, MN
- NPI 1275060030
-
dba Mayo Clinic Health System Pharmacy - Cannon Falls
- Clinic Pharmacy
- Cannon Falls, MN
- NPI 1699597468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1215272729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32021 COUNTRY 24 BLVD",
"city": "CANNON FALLS",
"state": "MN",
"postal_code": "550095003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32021 COUNTY 24 BLVD",
"city": "CANNON FALLS",
"state": "MN",
"postal_code": "550095003",
"telephone_number": "507-263-4221"
}
],
"practiceLocations": [
{
"address_1": "34 SW 89th St",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731398510",
"country_code": "US",
"telephone_number": "405-488-0750",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CHAD",
"middle_name": "DUANE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-10",
"last_updated": "2022-07-08",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "2204",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "12113",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cwilliams88037@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "32021 County 24 Blvd",
"city": "Cannon Falls",
"state": "MN",
"country_code": "US",
"postal_code": "550095003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cannon Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.