Individual provider Active NPI

Dennis A Williams, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Evans, GA
National Provider Identifier
1235131525
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
GA38402 Issued in GA
Practice address
4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone
(706) 396-7671
Fax
(706) 396-7676
NPI assigned
Jun 1, 2005
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X GA38402 GA Primary

Addresses

Primary practice location

4409 Evans to Locks Rd
Evans, GA 30809-3603

Mailing address

4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone (706) 396-7671

Other identifiers 2

IdentifierTypeStateIssuer
00616756BMedicaidGA
009938356MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20091118000027 GA Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 9133172117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Wright State University Boonshoft School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone 7063267671107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GA38402GAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Wilkers Group, LLC Current Accepting new patients
Pain Management & Rehabilitation Specialists, PC CurrentSince Jul 1, 2002 Accepting new patients
Pain Management & Rehabilitation Specialists, PC Current Accepting new patients

Locations

4409 Evans To Locks Rd
Evans, GA 30809
Phone (706) 396-7671

1067 Peachtree St
Louisville, GA 30434
Phone (478) 625-7000

Interoperability endpoints

  • Direct secure messaging: dwilliams@582.securemail.prognocis.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1235131525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 EVANS TO LOCKS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093603",
            "telephone_number": "706-396-7671",
            "fax_number": "706-396-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 EVANS TO LOCKS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093603",
            "telephone_number": "706-396-7671",
            "fax_number": "706-396-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DENNIS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "GA38402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00616756B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009938356",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.