Individual provider Active NPI

Judy T Williamson, CNM

  • Midwife
  • Riverdale, GA
National Provider Identifier
1386865921
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
RN145364 Issued in GA
Practice address
83 Upper Riverdale Road
BLDG 2 Suite 135
Riverdale, GA 30274
Phone
(770) 991-0778
Fax
(770) 991-7390
NPI assigned
May 1, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X RN145364 GA Primary

Addresses

Primary practice location

83 Upper Riverdale Road
BLDG 2 Suite 135
Riverdale, GA 30274

Mailing address

83 Upper Riverdale Road
BLDG 2 Suite 135
Riverdale, GA 30274
Phone (770) 991-0778

Other identifiers 1

IdentifierTypeStateIssuer
00857601DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN145364GAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
New Millennium Obsetrics & Gynecology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386865921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 UPPER RIVERDALE ROAD",
            "address_2": "BLDG 2 SUITE 135",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "770-991-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 UPPER RIVERDALE ROAD",
            "address_2": "BLDG 2 SUITE 135",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "770-991-0778",
            "fax_number": "770-991-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "JUDY",
        "middle_name": "T",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "GA",
            "license": "RN145364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00857601D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.