James Bertram Williams, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036099138 Issued in IL

Practice address

2420 W Nebraska Ave
Peoria, IL 61604-3112

Phone

(309) 680-5000

Fax

(309) 680-1002

NPI assigned

Aug 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Cardiac SurgeryAlso: Vascular Surgery

Education

Baylor College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Tennessee Healthcare Henry County Hospital Hospital, Paris, TN, CCN 440132

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: james.williams@1377.chartlogic.direct-ci.com

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.

• Heartland Vascular Care PLLC

  • Vascular & Interventional Radiology Physician
  • Peoria, IL
  • NPI 1134804420
  NPD
• Daniel M Couri LTD

  • Cardiovascular Disease Physician
  • Peoria, IL
  • NPI 1457770646
  NPD (past)
• Illinois Cardiac Surgery Associates SC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Peoria, IL
  • NPI 1114018439
  NPD (past)

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

• West Tennessee Healthcare Henry County

  • General Acute Care Hospital
  • Paris, TN
  • NPI 1497750244
  Care Compare affiliation

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1265433882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 W NEBRASKA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043112",
            "telephone_number": "309-680-5000",
            "fax_number": "309-680-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 W NEBRASKA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043112",
            "telephone_number": "309-680-5000",
            "fax_number": "309-680-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAMES",
        "middle_name": "BERTRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036099138",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036099138",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "P00059260",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099138",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0101/010794248-01",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NO",
            "identifier": "7232062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Williams Blake
• Felicia Williams-Triplett, RN
• Braden Williams, PA
• Charity Joy Williams, COTA
• Cooper Williams
• James R Williams, MD
• Kara Williams
• Katherine Nicole Williams, MSPAS, PA-C
• Kelsey Christine Williams
• Kristi Kae Williams, CNS-BC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.