John Richard Williams I, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7425 Issued in GA

Practice address

189 Bo James St Ste 105
Clayton, GA 30525-6199

Phone

(706) 782-0016

Fax

(706) 782-0180

NPI assigned

Nov 10, 2014

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in GA, NC2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Life Point Medical, LLCGroup PAC ID 1850679218, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stephens County Hospital Hospital, Toccoa, GA, CCN 110032
• Mountain Lakes Medical Center Hospital, Clayton, GA, CCN 111336

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.williams.1@14758.direct.athenahealth.com
• Direct secure messaging: jwilliams2018369@direct.trinity-health.org

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.

• Life Point Medical, LLC

  • Medical Specialty Clinic/Center
  • Clayton, GA
  • NPI 1154870533
  Medicare reassignment Care Compare group
• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Lithonia, GA
  • NPI 1124073721
  Medicare reassignment
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  NC

  Medicare reassignment
• Sound Physicians Emergency Medicine of Georgia PC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1447784988

  GA

  Medicare reassignment
• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Decatur, GA
  • NPI 1215982814
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Northeast Georgia Orthopaedics & Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Hoschton, GA
  • NPI 1093725327
  NPD (past)
• Northeast Georgia Orthopaedics & Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, GA
  • NPI 1427079185
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Professional Resources Management of Rabun, LLC

  dba Mountain Lakes Medical Center

  • Critical Access Hospital
  • Clayton, GA
  • NPI 1326191180
  Care Compare affiliation
• Stephens County Hospital Authority

  • Rural Acute Care Hospital
  • Toccoa, GA
  • NPI 1033191267
  Care Compare affiliation

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1396141974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 BO JAMES ST STE 105",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305256199",
            "telephone_number": "706-782-0016",
            "fax_number": "706-782-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 BO JAMES ST STE 105",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305256199",
            "telephone_number": "706-782-0016",
            "fax_number": "706-782-0180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 Clear Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lavonia",
            "state": "GA",
            "postal_code": "305534173",
            "country_code": "US",
            "telephone_number": "770-654-4682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 JESSE JEWELL PKWY SE",
            "address_2": "SUITE B",
            "address_purpose": "LOCATION",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013899",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1945 Beverly Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305012034",
            "country_code": "US",
            "telephone_number": "770-533-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175608",
            "country_code": "US",
            "telephone_number": "678-207-4477",
            "fax_number": "678-207-4478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Jesse Jewell Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013834",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13479",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7425",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "007425",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153646I",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "06705493",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153646G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153646J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153646K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153646L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153646H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1819077",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Lee Weber Jr., D.M.D.
• Wellstar MLMC Inc (Wellstar Mountain Lakes Medical Center)
• Wellstar MLMC Inc (Wellstar Mountain Lakes Medical Center)
• Wellstar MLMC Inc (Wellstar Mountain Lakes Medical Center)
• Laura P West, M.D.
• Paulette Williams, CDE, RD, & LD
• Rebecca Jo Williams, FNP-C
• Taylor Williams, APRN
• Anne E Wilzbacher
• Chester John Bato Yocor

• Physician Assistant in Clayton, GA
• Providers in Clayton, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.