Individual provider Active NPI

James McKinley Williams, MD, PHD

  • Otolaryngic Allergy Physician
  • Fremont, OH
National Provider Identifier
1235127606
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
088507 Issued in OH
Practice address
605 3Rd Ave
Suite a
Fremont, OH 43420-3269
Phone
(567) 201-2890
Fax
(567) 201-2893
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X 088507 OH Primary

Addresses

Primary practice location

605 3Rd Ave
Suite a
Fremont, OH 43420-3269

Mailing address

605 3Rd Ave
Suite a
Fremont, OH 43420-3269
Phone (567) 201-2890

Other identifiers 2

IdentifierTypeStateIssuer
0062143MedicaidOH
100095310BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120706000130 OH Practitioner - Otolaryngology 3577525146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyandot Memorial HospitalGroup PAC ID 1557340189, 70 clinicians

Practice addresses (Care Compare)

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone 41929449912157

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
18117OKMDPharmacist
088507OHMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyandot Memorial Hospital CurrentSince Dec 11, 2023 Accepting new patients
Wyandot Memorial Hospital CurrentSince Dec 11, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Claremore Physicians LLC Past Accepting new patients

Locations

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

Interoperability endpoints

  • Direct secure messaging: jwilliams227504@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1235127606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 3RD AVE",
            "address_2": "SUITE A",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203269",
            "telephone_number": "567-201-2890",
            "fax_number": "567-201-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 3RD AVE",
            "address_2": "SUITE A",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203269",
            "telephone_number": "567-201-2890",
            "fax_number": "567-201-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAMES",
        "middle_name": "MCKINLEY",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "OH",
            "license": "088507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062143",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100095310B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.