Individual provider Active NPI

Dianne Louise Williams, OD

  • Optometrist
  • Fort Bliss, TX
National Provider Identifier
1235129206
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5915 Issued in FL
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

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1235129206OtherNPI

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

LicenseStateTypeSpecialty
7308TXMDChiropractor
2440OKMDRegistered Dietitian
OPC5915FLMDOptometrist
1366SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Michael a. Campbell Past Accepting new patients
Optical Solutions Past Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 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.

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.

Verify at the official NPI Registry.