Individual provider Active NPI

Anthony Van Dyke Williams, MD, FACP

  • Internal Medicine Physician
  • Barre, VT
National Provider Identifier
1356348007
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0007830 Issued in VT
Practice address
225 S Main St
Barre, VT 05641-4881
Phone
(802) 479-3302
Fax
(802) 225-5720
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042-0007830 VT Primary

Addresses

Primary practice location

225 S Main St
Barre, VT 05641-4881

Mailing address

PO Box 547
Att: CVMC Finace Dept
Barre, VT 05641-0547
Phone (802) 479-3302

Other identifiers 1

IdentifierTypeStateIssuer
0009356MedicaidVT

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100209000692 VT Practitioner - Internal Medicine 2769419696 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0007830VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc Internal Medicine CurrentSince Dec 1, 2010 Accepting new patients

Locations

225 S Main St
Barre, VT 05641
Phone (802) 476-9242

77 Vine St
Barre, VT 05641
Phone (802) 225-1266

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1356348007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINACE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-479-3302",
            "fax_number": "802-225-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MAIN ST",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414881",
            "telephone_number": "802-479-3302",
            "fax_number": "802-225-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANTHONY",
        "middle_name": "VAN DYKE",
        "credential": "MD, FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0007830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009356",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barre, VT

Sources for this page

Verify at the official NPI Registry.