Individual provider Active NPI

Randall S Williams, MD

  • General Practice Physician
  • Chico, CA
National Provider Identifier
1245261114
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G068885 Issued in CA
Practice address
1040 Mangrove Ave
Chico, CA 95926-3509
Phone
(530) 345-0064
Fax
(530) 345-0080
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G068885 CA Primary

Addresses

Primary practice location

1040 Mangrove Ave
Chico, CA 95926-3509

Mailing address

1040 Mangrove Ave
Chico, CA 95926-3509
Phone (530) 345-0064

Other identifiers 1

IdentifierTypeStateIssuer
00G688850MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080710000694 CA Practitioner - General PracticePractitioner - Family Practice 5092887869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
Loma Linda University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mangrove Medical GroupGroup PAC ID 0143260687, 10 clinicians

Practice addresses (Care Compare)

1040 Mangrove Ave
Chico, CA 95926-3509
Phone 5303450064268

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy137
Upper gastrointestinal (GI) endoscopy for acid reflux46
Melanoma (skin cancer) excision1-10
Removal of skin lesions74
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G068885CAMDGeneral Practice Physician

Interoperability endpoints

  • Direct secure messaging: randall.williams.1@15385.direct.athenahealth.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245261114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MANGROVE AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263509",
            "telephone_number": "530-345-0064",
            "fax_number": "530-345-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MANGROVE AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263509",
            "telephone_number": "530-345-0064",
            "fax_number": "530-345-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RANDALL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G068885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G688850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.