Individual provider Active NPI

Lenita Rochell Williamson, MD

  • Orthopaedic Surgery Physician
  • Modesto, CA
National Provider Identifier
1245271253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G76941 Issued in CA
Practice address
2116 E Orangeburg Ave
Ste a
Modesto, CA 95355
Phone
(209) 577-1411
Fax
(209) 577-1236
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G76941 CA Primary

Addresses

Primary practice location

2116 E Orangeburg Ave
Ste a
Modesto, CA 95355

Mailing address

2401 E Orangeburg Ave Pmb374
Ste 675
Modesto, CA 95355
Phone (209) 577-1411

Other identifiers 1

IdentifierTypeStateIssuer
00G769410MedicaidCA

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
I20101213000342 CA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 5991992240 Practice locations: Modesto, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G76941CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eric L Giang DO Inc a Professional Corporation Orthopaedic Surgery PastSince Jun 21, 2020 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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245271253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E ORANGEBURG AVE PMB374",
            "address_2": "STE 675",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-577-1411",
            "fax_number": "209-577-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E ORANGEBURG AVE",
            "address_2": "STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-577-1411",
            "fax_number": "209-577-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "LENITA",
        "middle_name": "ROCHELL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G76941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G769410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.