Individual provider Active NPI

Timothy M Williams, MD

  • Anesthesiology Physician
  • Kingsport, TN
National Provider Identifier
1366443806
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20187 Issued in TN
Practice address
135 W Ravine Rd
Suite 5-B
Kingsport, TN 37660-3847
Phone
(423) 224-3460
Fax
(423) 224-3465
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20187 TN Primary

Addresses

Primary practice location

135 W Ravine Rd
Suite 5-B
Kingsport, TN 37660-3847

Mailing address

PO Box 535744
Atlanta, GA 30353-5510
Phone (844) 294-5114

Other identifiers 7

IdentifierTypeStateIssuer
3046114OtherBLUE CROSS OF TN
00013859OtherNHC CARE ADMINISTRATORS
5747074MedicaidVA
050039759OtherRAILROAD MEDICARE
069842OtherANTHEM BCBS
TN0100OtherJOHN DEERE
3056626MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20100920000784 TN Practitioner - Anesthesiology 2567587140 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Anesthesia Solutions IncGroup PAC ID 7315200664, 19 clinicians

Practice addresses (Care Compare)

2033 Meadowview LN
Suite 210
Kingsport, TN 37660-7569
Phone (423) 639-0941

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Anesthesia Solutions Inc. Anesthesiology CurrentSince Apr 15, 2025 Accepting new patients
American Anesthesiology of Tennessee, P.C. Anesthesiology CurrentSince Aug 1, 2019 Accepting new patients
Meadowview ASC, LLC PastSince Apr 15, 2025 Accepting new patients

Locations

320 Bristol West Blvd
Ste 1A
Bristol, TN 37620
Phone (423) 758-1030

130 W Stone Dr
Kingsport, TN 37660

2033 Meadowview Ln
Ste 210
Kingsport, TN 37660
Phone (423) 343-7820

10425 Wallace Alley St
Kingsport, TN 37663
Phone (423) 282-9011

Dept 888618
Knoxville, TN 37995

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Organizations & group practices 3

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1366443806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303535510",
            "telephone_number": "844-294-5114",
            "fax_number": "865-691-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD",
            "address_2": "SUITE 5-B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-224-3460",
            "fax_number": "423-224-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "20187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TN",
            "identifier": "3046114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHC CARE ADMINISTRATORS",
            "identifier": "00013859",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5747074",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050039759",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "069842",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056626",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.