Mark Williams, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA152965 Issued in OR

Practice address

691 Murphy Road
Suite 107
Medford, OR 97504-8383

Phone

(541) 789-6460

Fax

(541) 789-6461

NPI assigned

Oct 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rogue Valley PhysiciansGroup PAC ID 1850374240, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwilliams347768@oc.providencedirect.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Rogue Valley Physicians

  • Family Medicine Physician
  • Medford, OR
  • NPI 1699761932
  Medicare reassignment Care Compare group
• Rogue Valley Physicians

  dba Children & Adolescents

  • Primary Care Clinic/Center
  • Medford, OR
  • NPI 1881811842
  NPD
• Rogue Valley Physicians PC

  dba Family Practice Group

  • Primary Care Clinic/Center
  • Medford, OR
  • NPI 1114190121
  NPD

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

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Three Rivers Homecare, LLC

  dba Assured Home Health

  • Home Health Agency
  • Grants Pass, OR
  • NPI 1396977393
  Care Compare affiliation

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1265742662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EAST BARNETT ROAD",
            "address_2": "SUITE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048383",
            "telephone_number": "541-789-4281",
            "fax_number": "541-789-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 MURPHY ROAD",
            "address_2": "SUITE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048383",
            "telephone_number": "541-789-6460",
            "fax_number": "541-789-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA152965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilliams347768@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "870 S Front St Ste 200",
            "city": "Central Point",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975022779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey Gray Williams, M.D.
• Jessica Williams
• Kara L Williams, CADC-R
• Keith B. Williams, MD
• Leslie Michelle Williams
• Mark K Williams, RPH
• Michelle Williams
• Jeffrey Adam Williamson, LPC
• Judi Willingham
• Emma Faith Willis, COTA/L

• Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.