Organization Active NPI

Robin C Williams, MD, PA

  • Specialist
  • Batesville, AR
National Provider Identifier
1407060700
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R4485 Issued in AR
Legal business name
ROBIN C WILLIAMS, MD, PA
Practice address
411 Virginia Dr
Batesville, AR 72501-7329
Phone
(870) 698-9747
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Authorized official

Name
Dr. Robin C Williams, M.D.NPI 1083680862
Title
Owner
Phone
(870) 698-9747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X R4485 AR Primary

Addresses

Primary practice location

411 Virginia Dr
Batesville, AR 72501-7329

Mailing address

411 Virginia Dr
Batesville, AR 72501-7329
Phone (870) 698-9747

Other identifiers 2

IdentifierTypeStateIssuer
136360002MedicaidAR
133120000OtherARQUALCHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120416000472 AR Part B Supplier - Clinic/Group Practice 5193986396 Receives reassigned benefits from 1 practitioner
Practice locations: Batesville, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0902382Robin C Williams MD PA411 Virginia Drive, Batesville, AR 72501Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

411 Virginia Dr
Batesville, AR 72501
Phone (870) 698-9747

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1407060700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 VIRGINIA DR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017329",
            "telephone_number": "870-698-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 VIRGINIA DR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017329",
            "telephone_number": "870-698-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBIN C WILLIAMS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-698-9747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "R4485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136360002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "133120000",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.