Individual provider Active NPI

Thomas Max Williams Jr., BACHELORS

  • Rehabilitation Practitioner
  • Los Angeles, CA
National Provider Identifier
1235262007
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
11601 S Western Ave
Los Angeles, CA 90047-5006
Phone
(323) 242-5000
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

11601 S Western Ave
Los Angeles, CA 90047-5006

Mailing address

11601 S Western Ave
Los Angeles, CA 90047-5006
Phone (323) 242-5000

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shields for Families Past Accepting new patients

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1235262007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475006",
            "telephone_number": "323-242-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475006",
            "telephone_number": "323-242-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "THOMAS",
        "middle_name": "MAX",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "BACHELORS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.