Individual provider Active NPI

Steven Shane Williams, PAC

  • Physician Assistant
  • Salem, VA
National Provider Identifier
1285677740
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002684 Issued in VA
Practice address
1802 Braeburn Dr
Salem, VA 24153-7357
Phone
(540) 772-3530
Fax
(540) 776-2036
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002684 VA Primary

Addresses

Primary practice location

1802 Braeburn Dr
Salem, VA 24153-7357

Mailing address

1802 Braeburn Dr
Salem, VA 24153-7357
Phone (540) 772-3530

Other identifiers 2

IdentifierTypeStateIssuer
1285677740MedicaidVA
P00449576OtherVAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20080118000491 VA Practitioner - Physician Assistant 1153356795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

1 Arh Lane
Suite 103
Low Moor, VA 24457-0007
Phone (540) 969-9293

101 Knotbreak Rd
Salem, VA 24153-5404
Phone (540) 444-4020

1802 Braeburn Dr
Salem, VA 24153-7357

1900 Electric Rd
Salem, VA 24153-7474

Hospital & facility affiliations

  • Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
  • Lewisgale Hospital Alleghany Hospital, Low Moor, VA, CCN 490126
  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Merit-based Incentive Payment System (MIPS)

Final score
82.67 of 100Reported as group
Quality
66.8
Promoting interoperability
100
Improvement activities
40
Cost
75.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: steven.williams@hca6.eclinicaldirectplus.com

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1285677740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3530",
            "fax_number": "540-776-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3530",
            "fax_number": "540-776-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEVEN",
        "middle_name": "SHANE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285677740",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00449576",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.