Individual provider Active NPI

Annette June Williamson, OD

  • Optometrist
  • Bolling Air Force Base, DC
National Provider Identifier
1235201781
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4227 Issued in TX
Practice address
238 Brookley Avenue
Bolling Air Force Base, DC 20032-7050
Phone
(202) 767-1868
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4227 TX Primary

Addresses

Primary practice location

238 Brookley Avenue
Bolling Air Force Base, DC 20032-7050

Mailing address

4400 Fredericksburg Rd
Ste 107
San Antonio, TX 78201-1969
Phone (210) 737-1926

Other names 1

  • Dr. Annette June Bower Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221000531 TX Practitioner - Optometry 9638463821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox and Sheppard, P.a.Group PAC ID 7810270394, 4 clinicians

Practice addresses (Care Compare)

4400 Fredericksburg Rd
Suite 107
San Antonio, TX 78201-1969
Phone (210) 737-1926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4227TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox and Sheppard, P.a. Optometrist CurrentSince Feb 13, 2017 Accepting new patients

Locations

4400 Fredericksburg Rd
Ste 107
San Antonio, TX 78201
Phone (210) 737-1926

Organizations & group practices 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1235201781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 FREDERICKSBURG RD",
            "address_2": "STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782011969",
            "telephone_number": "210-737-1926",
            "fax_number": "210-737-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 BROOKLEY AVENUE",
            "city": "BOLLING AIR FORCE BASE",
            "state": "DC",
            "postal_code": "200327050",
            "telephone_number": "202-767-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "ANNETTE",
        "middle_name": "JUNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "BOWER",
            "middle_name": "JUNE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolling Air Force Base, DC

Sources for this page

Verify at the official NPI Registry.