Individual provider Active NPI

Colin McWilliams

  • Gerontology Nurse Practitioner
  • Duxbury, MA
National Provider Identifier
1396464319
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG07220180 Issued in MA
Practice address
251 Tremont St
Duxbury, MA 02332-4828
Phone
(781) 249-5960
NPI assigned
Aug 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X AG07220180 MA Primary

Addresses

Primary practice location

251 Tremont St
Duxbury, MA 02332-4828

Mailing address

251 Tremont St
Duxbury, MA 02332-4828
Phone (781) 249-5960

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Cmcwill@yahoo.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221213001944 MA Practitioner - Nurse Practitioner 5991174021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Plymouth County Behavioral Health LLCGroup PAC ID 9335242510, 2 clinicians

Practice addresses (Care Compare)

81 Samoset St
Suite 3
Plymouth, MA 02360-4500
Phone (508) 830-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG07220180MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Insight Inc Multi-Specialty CurrentSince Nov 22, 2022 Accepting new patients
Plymouth County Behavioral Health LLC Multi-Specialty CurrentSince Dec 1, 2022 Accepting new patients
Mindful Mental Health LLC CurrentSince Jul 21, 2024 Accepting new patients

Locations

105 Webster St
Ste 8
Hanover, MA 02339
Phone (781) 312-7457

81 Samoset St
Ste 3
Plymouth, MA 02360
Phone (508) 830-0012

81 Samoset St
Plymouth, MA 02360
Phone (508) 747-0587

Organizations & group practices 3

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1396464319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 TREMONT ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324828",
            "telephone_number": "781-249-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 TREMONT ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324828",
            "telephone_number": "781-249-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "COLIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "AG07220180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cmcwill@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "251 Tremont St",
            "city": "Duxbury",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023324828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duxbury, MA

Sources for this page

Verify at the official NPI Registry.