Individual provider Active NPI

Jeffery Scott Williams, D.C.

  • Chiropractor
  • Amarillo, TX
National Provider Identifier
1356365258
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7359 Issued in TX
Practice address
3501 W 45TH Ave
Suite T
Amarillo, TX 79109-5679
Phone
(806) 355-3000
Fax
(806) 418-2305
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7359 TX Primary

Addresses

Primary practice location

3501 W 45TH Ave
Suite T
Amarillo, TX 79109-5679

Mailing address

2045 S Hughes St
Amarillo, TX 79109-2265
Phone (806) 364-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061003000627 TX Practitioner - Chiropractic 2860497419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3501 SW 45TH Ave
Suite T
Amarillo, TX 79109-5676
Phone (806) 355-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7359TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Stone Integrated Medical PLLC CurrentSince Jul 23, 2021 Accepting new patients
Apacc Inc Chiropractor CurrentSince Aug 23, 2009 Accepting new patients

Locations

3501 SW 45th Ave
Ste T
Amarillo, TX 79109
Phone (806) 355-3000

Organizations & group practices 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1356365258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 S HUGHES ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791092265",
            "telephone_number": "806-364-9000",
            "fax_number": "806-364-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W 45TH AVE",
            "address_2": "SUITE T",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095679",
            "telephone_number": "806-355-3000",
            "fax_number": "806-418-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JEFFERY",
        "middle_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "7359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.