NPIMap

Organization Active NPI

Williamsburg Emergency Physicians

  • Emergency Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1225079650
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
WILLIAMSBURG EMERGENCY PHYSICIANS
Practice address
100 Sentara Cir
Williamsburg, VA 23188-5713
Phone
(757) 221-0055
NPI assigned
Jun 9, 2006
Last updated
Apr 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Authorized official

Name
Courtney Zydron, MDNPI 1346483567
Title
Ao
Phone
(757) 719-9003

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Emergency Care Clinic/Center 261QE0002X

Addresses

Primary practice location

100 Sentara Cir
Williamsburg, VA 23188-5713

Mailing address

PO Box 2915
Williamsburg, VA 23187-2915
Phone (757) 221-0055

Other identifiers 1

IdentifierTypeStateIssuer
CE8290OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040608000155 VA Part B Supplier - Clinic/Group Practice 3274516703 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
Practice locations: Williamsburg, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 56

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 56

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1225079650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2915",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231872915",
            "telephone_number": "757-221-0055",
            "fax_number": "757-221-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SENTARA CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885713",
            "telephone_number": "757-221-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG EMERGENCY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "ZYDRON",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "757-719-9003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE8290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.