Tyler David Williams, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4301111934 Issued in MI

Practice address

231 Albert Sabin Way
Cincinnati, OH 45267-2827

Phone

(513) 558-5861

NPI assigned

Jun 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1386174209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452672827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452672827",
            "telephone_number": "513-558-5861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22151 Moross Rd Ste 214",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362151",
            "country_code": "US",
            "telephone_number": "313-343-4867",
            "fax_number": "313-343-3280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301111934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4301111934",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tira Michelle Williams, RN,BSN
• Todd Edward Williams, D.D.S.
• Toni Jean Williams, LPN
• Trenisha Williams
• Tristen Williams
• Tyra Williams
• Van Don Williams II, MD
• Victoria F Williams
• Vincent Patrick Williams, DDS
• Wayne C Williams

• Student in an Organized Health Care Education/Training Program in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.