Individual provider Active NPI

Robert A Williams Jr., M.D.

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1245400951
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A99934 Issued in CA
Practice address
3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone
(805) 652-6656
NPI assigned
Mar 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A99934 CA Primary

Addresses

Primary practice location

3291 Loma Vista Rd
Ventura, CA 93003-3099

Mailing address

10900 W 44TH Ave
Unit 100
Wheat Ridge, CO 80033-2761
Phone (720) 923-1250

Other identifiers 1

IdentifierTypeStateIssuer
A99934OtherSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20100201000792 CO Practitioner - Geriatric Medicine 9032252994

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99934CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philippe G Lopez MD PC PastSince Jun 16, 2024 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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1245400951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE",
            "address_2": "UNIT 100",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332761",
            "telephone_number": "720-923-1250",
            "fax_number": "303-284-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-652-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A99934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A99934",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.