Active NPI
Dianne Louise Williams, OD
- Optometrist
- Fort Bliss, TX
National Provider Identifier
1235129206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC5915
- Practice address
- 18511 Highlander Medics St
Fort Bliss, TX 79906-5327 - Phone
- (915) 735-5696
- NPI assigned
- Oct 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7308 | TX | |
| Optometrist | 152W00000X | 1366 | SC | |
| Vision Therapy Optometrist | 152WV0400X | 1366 | SC | |
| Optometrist | 152W00000X | OPC5915 | FL | Primary |
Addresses
Primary practice location
18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Mailing address
18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Other practice location 1
204 West Hill Blvd
Bldg 364
JB Charleston, SC 29404
Phone (843) 963-6855
Other practice location 2
14th Medical Group 201 Independence Drive
Columbus, MS 39710-0001
Phone (662) 434-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235129206 | Other | NPI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7308 | TX | MD | Chiropractor |
| 2440 | OK | MD | Registered Dietitian |
| OPC5915 | FL | MD | Optometrist |
| 1366 | SC | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Michael a. Campbell | Past | Accepting new patients | |
| Optical Solutions | Past | Accepting new patients | |
| Northeastern State University College of Optometry | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Clinic/Center
- Hilton Head Island, SC
- NPI 1629276605
-
- Optometrist
- Tahlequah, OK
- NPI 1437106333
-
- Eyewear Supplier
- Hilton Head Island, SC
- NPI 1649319930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1235129206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18511 HIGHLANDER MEDICS ST",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "799065327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18511 HIGHLANDER MEDICS ST",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "799065327",
"telephone_number": "915-735-5696"
}
],
"practiceLocations": [
{
"address_1": "204 West Hill Blvd",
"address_2": "Bldg 364",
"address_purpose": "LOCATION",
"city": "JB Charleston",
"state": "SC",
"postal_code": "29404",
"country_code": "US",
"telephone_number": "843-963-6855",
"fax_number": "843-963-6812",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14th Medical Group 201 Independence Drive",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "MS",
"postal_code": "397100001",
"country_code": "US",
"telephone_number": "662-434-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DIANNE",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-21",
"last_updated": "2024-03-18",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "7308",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "1366",
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "SC",
"license": "1366",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC5915",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1235129206",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.