NPIMap

Organization Active NPI

Jeffrey W. Williams, O.D. & Associates, PA

  • Eyewear Supplier
  • New Richmond, WI
National Provider Identifier
1265502272
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1038 Issued in WI
Legal business name
JEFFREY W. WILLIAMS, O.D. & ASSOCIATES, PA
Practice address
302 S Knowles Ave
New Richmond, WI 54017-1731
Phone
(715) 246-2419
Fax
(715) 246-9434
NPI assigned
Nov 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey W. Williams, O.D.NPI 1750334074
Title
President
Phone
(763) 712-9854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1038 WI Primary

Addresses

Primary practice location

302 S Knowles Ave
New Richmond, WI 54017-1731

Mailing address

3480 Bunker Lake Blvd NW
Andover, MN 55304-2085
Phone (763) 712-9854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061116000158 WI Part B Supplier - Clinic/Group Practice 6709781180 Receives reassigned benefits from 2 practitioners
Practice locations: New Richmond, WI
O20080903000564 MN Part B Supplier - Clinic/Group Practice 6709781180 Receives reassigned benefits from 4 practitioners
Practice locations: Andover, MN; North Oaks, MN; Roseville, MN; Saint Francis, MN

National Provider Directory

National Provider Directory

Locations

3480 Bunker Lake Blvd NW
Ste 101
Andover, MN 55304
Phone (763) 712-9854

3480 Bunker Lake Blvd NW
Andover, MN 55304
Phone (763) 427-4780

23168 Saint Francis Blvd NW
Ste 300
Saint Francis, MN 55070
Phone (763) 753-6109

1835 County Road C W
Ste 240
Saint Paul, MN 55113
Phone (651) 638-1555

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265502272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 BUNKER LAKE BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553042085",
            "telephone_number": "763-712-9854",
            "fax_number": "763-506-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S KNOWLES AVE",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171731",
            "telephone_number": "715-246-2419",
            "fax_number": "715-246-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W. WILLIAMS, O.D. & ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-712-9854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WI",
            "license": "1038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richmond, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.