Individual provider Active NPI

Cleveland Williams, M.D

  • General Practice Physician
  • Washington, DC
National Provider Identifier
1417197435
Registry record updated Jul 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD13627 Issued in DC
Practice address
2041 Martin Luther King Jr Ave SE
Suite LL2
Washington, DC 20020-7024
Phone
(202) 450-5891
NPI assigned
Mar 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD13627 DC Primary

Addresses

Primary practice location

2041 Martin Luther King Jr Ave SE
Suite LL2
Washington, DC 20020-7024

Mailing address

2041 Martin Luther King Jr Ave SE Ste LL2
Washington, DC 20020-7025
Phone (402) 770-2761

Other identifiers 1

IdentifierTypeStateIssuer
MD13627OtherDCDC LICENSE

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Medical Ctr LLC Past Accepting new patients

Organizations & group practices 1

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": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722124800000",
    "number": "1417197435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 MARTIN LUTHER KING JR AVE SE STE LL2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200207025",
            "telephone_number": "402-770-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 MARTIN LUTHER KING JR AVE SE",
            "address_2": "SUITE LL2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200207024",
            "telephone_number": "202-450-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CLEVELAND",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-03",
        "last_updated": "2024-07-28",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DC",
            "license": "MD13627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC LICENSE",
            "identifier": "MD13627",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2024; 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.