NPIMap

Organization Active NPI

General Vascular Surgery Specialist P a

  • Surgery Physician
  • McComb, MS
National Provider Identifier
1376647453
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
09423 Issued in MS
Legal business name
GENERAL VASCULAR SURGERY SPECIALIST P A
Practice address
1311 Aston Avenue
McComb, MS 39648-2825
Phone
(601) 684-2481
Fax
(601) 684-2488
NPI assigned
Sep 11, 2006
Last updated
Jan 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Authorized official

Name
Steven Charles Williams, MDNPI 1942412887
Title
President
Phone
(601) 684-2481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 09423 MS Primary

Addresses

Primary practice location

1311 Aston Avenue
McComb, MS 39648-2825

Mailing address

1311 Aston Ave
McComb, MS 39648-2825
Phone (601) 684-2481

Other identifiers 7

IdentifierTypeStateIssuer
1317934OtherLALOUISIANA MEDICAID
770000345OtherMSRAILROAD MEDICARE
0055406OtherMSMISSISSIPPI SELECT
1730019OtherMSUNITED HEALTHCARE
0200000153OtherMSINDIVIDUAL MEDICARE PTAN
412909978AOtherMSBLUECROSS BLUESHIELD
00115579MedicaidMS

Other names 1

  • Steven C Williams MD Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1376647453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482825",
            "telephone_number": "601-684-2481",
            "fax_number": "601-684-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 ASTON AVENUE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482825",
            "telephone_number": "601-684-2481",
            "fax_number": "601-684-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL VASCULAR SURGERY SPECIALIST P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-684-2481",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MS",
            "license": "09423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA MEDICAID",
            "identifier": "1317934",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "770000345",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI SELECT",
            "identifier": "0055406",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1730019",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PTAN",
            "identifier": "0200000153",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "412909978A",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115579",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Steven C Williams MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.