Individual provider Active NPI

Austin Gregory Williams

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1396201554
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12703 Issued in FL
Practice address
4211 W Boy Scout Blvd Ste 450
Tampa, FL 33607-5724
Phone
(813) 445-6550
Fax
(813) 445-6505
NPI assigned
Feb 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12703 FL Primary

Addresses

Primary practice location

4211 W Boy Scout Blvd Ste 450
Tampa, FL 33607-5724

Mailing address

11411 Blue Lilac Ave
Riverview, FL 33578-3711
Phone (561) 253-4769

Other practice location 1

4040 Tampa Rd
Oldsmar, FL 34677-3205
Phone (813) 818-7499

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12703FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Conforti Chiropractic & Wellness Center Inc Chiropractor CurrentSince Mar 1, 2022 Accepting new patients
Crai Spines Chiropractor CurrentSince Jun 14, 2023 Accepting new patients
Jeff Davis D C PA Chiropractor Past Accepting new patients
Back to Wellness Chiropractic Inc Chiropractor PastSince Apr 1, 2023 Accepting new patients

Locations

4040 Tampa Rd
Oldsmar, FL 34677
Phone (813) 818-7499

8400 113th St
Seminole, FL 33772
Phone (727) 201-4549

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1396201554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11411 BLUE LILAC AVE",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783711",
            "telephone_number": "561-253-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 W BOY SCOUT BLVD STE 450",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075724",
            "telephone_number": "813-445-6550",
            "fax_number": "813-445-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4040 Tampa Rd",
            "address_purpose": "LOCATION",
            "city": "Oldsmar",
            "state": "FL",
            "postal_code": "346773205",
            "country_code": "US",
            "telephone_number": "813-818-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AUSTIN",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.