NPIMap

Individual provider Active NPI

Michelle H Williamson, MD

  • Family Medicine Physician
  • Appleton, WI
National Provider Identifier
1376652990
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49553 Issued in WI
Practice address
3916 N Intertech CT
Appleton, WI 54913-6957
Phone
(920) 996-1000
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49553 WI Primary

Addresses

Primary practice location

3916 N Intertech CT
Appleton, WI 54913-6957

Mailing address

3916 N Intertech CT
Appleton, WI 54913-6957
Phone (920) 996-1046

Other identifiers 1

IdentifierTypeStateIssuer
34711700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061009000112 WI Practitioner - Family Practice 7517963945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Associates of Appleton, LTDGroup PAC ID 1052348612, 31 clinicians

Practice addresses (Care Compare)

3916 N Intertech CT
Appleton, WI 54913-6957
Phone (920) 996-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Associates of Appleton, LTD Family Medicine CurrentSince Jan 1, 2017 Accepting new patients

Locations

3916 N Intertech Ct
Appleton, WI 54913
Phone (920) 996-1000

Interoperability endpoints

  • Direct secure messaging: mwilliamson173752@direct.thedacare.org

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.

Hospital & facility affiliations 12

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1376652990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 N INTERTECH CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549136957",
            "telephone_number": "920-996-1046",
            "fax_number": "920-996-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 N INTERTECH CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549136957",
            "telephone_number": "920-996-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MICHELLE",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "49553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34711700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.