Organization Active NPI

John V. Williams, M.D., PA

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1316402886
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JOHN V. WILLIAMS, M.D., PA
Practice address
10071 Pines Blvd Ste a
Pembroke Pines, FL 33024-6182
Phone
(954) 666-4650
Fax
(954) 908-3095
NPI assigned
Feb 8, 2019
Last updated
Feb 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Authorized official

Name
Dr. John V Williams, MDNPI 1609863489
Title
Physician/Owner
Phone
(954) 666-4650

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10071 Pines Blvd Ste a
Pembroke Pines, FL 33024-6182

Mailing address

6011 SW 136TH Ave
Southwest Ranches, FL 33330-3701
Phone (954) 666-4560

Other identifiers 1

IdentifierTypeStateIssuer
045678101MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200527002587 FL Part B Supplier - Clinic/Group Practice 4789005877 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Locations

10071 Pines Blvd
Ste A
Pembroke Pines, FL 33024
Phone (954) 442-0025

Practitioners & affiliated clinicians

Practitioners 2

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": "1549584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549584000000",
    "number": "1316402886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 SW 136TH AVE",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333303701",
            "telephone_number": "954-666-4560",
            "fax_number": "954-908-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10071 PINES BLVD STE A",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246182",
            "telephone_number": "954-666-4650",
            "fax_number": "954-908-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN V. WILLIAMS, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "954-666-4650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045678101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.