Organization Active NPI

Williamsmd LLC

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1225505571
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WILLIAMSMD LLC
Practice address
1700 66TH St N Ste 302
St Petersburg, FL 33710-5500
Phone
(727) 547-0239
Fax
(727) 547-0523
NPI assigned
Oct 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Luke C Williams, MDNPI 1366702441
Title
Owner
Phone
(727) 221-2297

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1700 66TH St N Ste 302
St Petersburg, FL 33710-5500

Mailing address

6016 Kipps Colony Dr E
Gulfport, FL 33707-3967
Phone (520) 260-6046

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181228000893 FL Part B Supplier - Clinic/Group Practice 3375888076 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

5901 Sun Blvd
Ste 206
St Petersburg, FL 33715
Phone (727) 310-0616

1700 66th St N
St Petersburg, FL 33710
Phone (727) 518-6444

1700 66th St N
Ste 302
St Petersburg, FL 33710
Phone (727) 547-0239

6701 38th Ave N
Ste C
St Petersburg, FL 33710
Phone (727) 479-3551

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1225505571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 KIPPS COLONY DR E",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337073967",
            "telephone_number": "520-260-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 66TH ST N STE 302",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105500",
            "telephone_number": "727-547-0239",
            "fax_number": "727-547-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-221-2297",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.