NPIMap

Organization Active NPI

Robert S McWilliam MD LLC

  • Psychiatry Physician
  • Woodbury, CT
National Provider Identifier
1215486261
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
022885 Issued in CT
Legal business name
ROBERT S MCWILLIAM MD LLC
Practice address
4 S Pomperaug Ave
Woodbury, CT 06798-3709
Phone
(203) 266-0404
Fax
(203) 263-0511
NPI assigned
Sep 30, 2016
Last updated
Sep 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Robert S McWilliam, MDNPI 1619071602
Title
Owner
Phone
(203) 266-0404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 022885 CT Primary

Addresses

Primary practice location

4 S Pomperaug Ave
Woodbury, CT 06798-3709

Mailing address

4 S Pomperaug Ave
Woodbury, CT 06798-3709
Phone (203) 266-0404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161215000257 CT Part B Supplier - Clinic/Group Practice 6800176553 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, CT

National Provider Directory

National Provider Directory

Locations

4 S Pomperaug Ave
Woodbury, CT 06798
Phone (203) 263-2020

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1215486261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S POMPERAUG AVE",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983709",
            "telephone_number": "203-266-0404",
            "fax_number": "203-263-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S POMPERAUG AVE",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983709",
            "telephone_number": "203-266-0404",
            "fax_number": "203-263-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT S MCWILLIAM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "MCWILLIAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-266-0404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "022885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.