Individual provider Active NPI

Timothy B Williams, D.O.

  • Pediatrics Physician
  • Plant City, FL
National Provider Identifier
1215909262
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS7802 Issued in FL
Practice address
511 W Alexander St
Suite 2
Plant City, FL 33563-7116
Phone
(813) 659-9800
Fax
(813) 659-9807
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS7802 FL Primary

Addresses

Primary practice location

511 W Alexander St
Suite 2
Plant City, FL 33563-7116

Mailing address

511 W Alexander St
Suite 2
Plant City, FL 33563-7116
Phone (813) 659-9800

Other identifiers 1

IdentifierTypeStateIssuer
256690700MedicaidFL

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS7802FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plant City Pediatrics, PA Pediatrics Current Accepting new patients

Locations

2370 Walden Woods Dr
Ste A
Plant City, FL 33563
Phone (813) 659-9800

2370 Walden Woods Dr
Plant City, FL 33563

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDBAA/Endpoint/JBDBAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1215909262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W ALEXANDER ST",
            "address_2": "SUITE 2",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637116",
            "telephone_number": "813-659-9800",
            "fax_number": "813-659-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W ALEXANDER ST",
            "address_2": "SUITE 2",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637116",
            "telephone_number": "813-659-9800",
            "fax_number": "813-659-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS7802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256690700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.