Individual provider Active NPI

William R Womack, MD

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1396716874
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4471 Issued in AZ
Practice address
1525 N Granite Reef Rd
Ste 7
Scottsdale, AZ 85257-3998
Phone
(480) 994-3432
Fax
(480) 994-5682
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4471 AZ Primary

Addresses

Primary practice location

1525 N Granite Reef Rd
Ste 7
Scottsdale, AZ 85257-3998

Mailing address

PO Box 3297
Scottsdale, AZ 85271-3297
Phone (000) 000-0000

Other identifiers 1

IdentifierTypeStateIssuer
208951MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050715000625 AZ Practitioner - Family Practice 6406882976 Practice locations: Scottsdale, AZ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4471AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barefoot Doctors Healthcare PC Past Accepting new patients
Put Your Feet First, PC Past Accepting new patients

Organizations & group practices 2

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1396716874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3297",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852713297",
            "telephone_number": "000-000-0000",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 N GRANITE REEF RD",
            "address_2": "STE 7",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573998",
            "telephone_number": "480-994-3432",
            "fax_number": "480-994-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "4471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208951",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.