Individual provider Active NPI

Minnette Williams, M.D.

  • Cardiovascular Disease Physician
  • Riverdale, GA
National Provider Identifier
1376768259
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
62632 Issued in GA
Practice address
6507 Professional PL
Riverdale, GA 30274-4941
Phone
(770) 991-2100
Fax
(770) 991-1385
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2004021615 MO
Clinical Cardiac Electrophysiology Physician 207RC0001X 062632 GA
Cardiovascular Disease Physician 207RC0000X 62632 GA Primary

Addresses

Primary practice location

6507 Professional PL
Riverdale, GA 30274-4941

Mailing address

6507 Professional PL
Riverdale, GA 30274-4941
Phone (770) 991-2100

Other identifiers 1

IdentifierTypeStateIssuer
880399518AMedicaidGA

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
I20090904000219 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac Electrophysiology 4981784634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology, Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Southern Regional Medical Center Hospital, Riverdale, GA, CCN 110165

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004021615MOMDCardiovascular Disease Physician
062632GAMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC CurrentSince Sep 26, 2022 Accepting new patients
The Emory Clinic Inc Cardiovascular Disease CurrentSince Apr 1, 2023 Accepting new patients
Emory Health Care Past Accepting new patients
Ecc Hospitalist Services PC Past Accepting new patients
Southern Heart Specialists, P.C. Cardiovascular Disease Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

1776 Old Spring House Ln
Atlanta, GA 30338
Phone (770) 454-0091

4899 Bill Gardner Pkwy
Locust Grove, GA 30248

101 World Dr
Peachtree City, GA 30269

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

6507 Professional Pl
Ste E
Riverdale, GA 30274
Phone (770) 991-2100

6507 Professional Pl
Riverdale, GA 30274
Phone (770) 991-2100

1050 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (404) 778-8605

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Interoperability endpoints

  • Direct secure messaging: mwilliams57966@direct.emory.org

Organizations & group practices 5

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 3

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1376768259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 PROFESSIONAL PL",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744941",
            "telephone_number": "770-991-2100",
            "fax_number": "770-991-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 PROFESSIONAL PL",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744941",
            "telephone_number": "770-991-2100",
            "fax_number": "770-991-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MINNETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2004021615",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "GA",
            "license": "062632",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "62632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880399518A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.