Individual provider Active NPI

Michael Anthony Williams, MD

  • Surgery Physician
  • Vidalia, GA
National Provider Identifier
1376504647
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
38650 Issued in GA
Practice address
1604 Meadows LN
Vidalia, GA 30474-8914
Phone
(912) 245-4179
Fax
(912) 403-3346
NPI assigned
Mar 28, 2006
Last updated
May 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 38650 GA
Surgery Physician 208600000X 38650 GA Primary

Addresses

Primary practice location

1604 Meadows LN
Vidalia, GA 30474-8914

Mailing address

PO Box 648
Vidalia, GA 30475-0648
Phone (912) 245-4179

Other practice location 1

10 Doctors St
Metter, GA 30439-3337
Phone (912) 685-5715

Other practice location 2

14 Doctors St
Metter, GA 30439
Phone (912) 685-1701

Other identifiers 2

IdentifierTypeStateIssuer
00600575CMedicaidGA
000600575FMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20031210000006 GA Practitioner - General SurgeryPractitioner - General Practice 9032015110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: General Practice
Education
Morehouse School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Cedar St
Metter, GA 30439-3338
Phone (912) 685-5741

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.58 of 100Reported as group
Quality
51.64
Improvement activities
0
Cost
70.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38650GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors to Go, LLC CurrentSince Feb 1, 2025 Accepting new patients
Hospital Authority of Candler County CurrentSince Jan 1, 2020 Accepting new patients
Hospital Authority of Candler County Current Accepting new patients
Meadows Regional Medical Center Inc Current Accepting new patients
Hospital Authority of Candler County CurrentSince Jan 1, 2020 Accepting new patients
Hospital Authority of Candler County PastSince Mar 28, 2021 Accepting new patients
Hospital Authority of Candler County Past Accepting new patients

Locations

200 N River St
Claxton, GA 30417
Phone (912) 739-2611

10 Doctors St
Metter, GA 30439
Phone (912) 685-5715

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

1604 Meadows Ln
Vidalia, GA 30474
Phone (912) 245-4179

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23328/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.williams.1@23328.direct.athenahealth.com
  • Direct secure messaging: michael.williams@gadirect.net
  • Direct secure messaging: michael.williams@healthiealerts.org
  • Direct secure messaging: michael.williams@mrmc.gadirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1376504647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750648",
            "telephone_number": "912-245-4179",
            "fax_number": "912-403-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 MEADOWS LN",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748914",
            "telephone_number": "912-245-4179",
            "fax_number": "912-403-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Doctors St",
            "address_purpose": "LOCATION",
            "city": "Metter",
            "state": "GA",
            "postal_code": "304393337",
            "country_code": "US",
            "telephone_number": "912-685-5715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Doctors St",
            "address_purpose": "LOCATION",
            "city": "Metter",
            "state": "GA",
            "postal_code": "30439",
            "country_code": "US",
            "telephone_number": "912-685-1701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "38650",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "38650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00600575C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000600575F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.