Individual provider Active NPI

Shawn S Williamson, M.D.

  • Emergency Medicine Physician
  • New London, WI
National Provider Identifier
1386808319
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
53739-20 Issued in WI
Practice address
1405 Mill St
New London, WI 54961-2155
Phone
(920) 531-2021
NPI assigned
Jul 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 53739-20 WI Primary

Addresses

Primary practice location

1405 Mill St
New London, WI 54961-2155

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 531-2021

Other practice location 1

1506 South Oneida Street
appleton, WI 54915
Phone (920) 738-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110708000541 WI Practitioner - Emergency Medicine 7214115542 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53739-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Medical Center - New London, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jun 11, 2022 Accepting new patients
Thedacare Medical Center - New London, Inc CurrentSince Jun 11, 2022 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jun 11, 2022 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Emergency Medicine CurrentSince Jun 11, 2022 Accepting new patients
Thedacare Regional Medical Center - Appleton, Inc. CurrentSince Jan 19, 2026 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jun 11, 2022 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jun 11, 2022 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Jun 11, 2022 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
Thedacare Medical Center - Wild Rose, Inc CurrentSince Jan 1, 2025 Accepting new patients
Thedacare Regional Medical Center - Appleton Inc. CurrentSince Jan 19, 2026 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Jun 11, 2022 Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

250 W 6th Ave
Oshkosh, WI 54902
Phone (920) 237-5000

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

601 Grove Ave
Wild Rose, WI 54984
Phone (888) 287-4488

Interoperability endpoints

  • Direct secure messaging: swilliamson323970@direct.thedacare.org

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1386808319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-531-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-531-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1506 South Oneida Street",
            "address_purpose": "LOCATION",
            "city": "appleton",
            "state": "WI",
            "postal_code": "54915",
            "country_code": "US",
            "telephone_number": "920-738-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "SHAWN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "53739-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

Verify at the official NPI Registry.