Individual provider Active NPI

Bruce R Williams, MD

  • Internal Medicine Physician
  • Enterprise, AL
National Provider Identifier
1417907791
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00007478 Issued in AL
Practice address
805 E Lee St
Suite C
Enterprise, AL 36330-2368
Phone
(334) 348-8818
Fax
(334) 393-8773
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00007478 AL Primary

Addresses

Primary practice location

805 E Lee St
Suite C
Enterprise, AL 36330-2368

Mailing address

805 E Lee St
Suite C
Enterprise, AL 36330-2368
Phone (334) 348-8818

Other identifiers 2

IdentifierTypeStateIssuer
000028379MedicaidAL
51028379OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100201000106 AL Practitioner - Internal Medicine 8224171103 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Troy Regional Physicians IncGroup PAC ID 1850587361, 17 clinicians

Practice addresses (Care Compare)

1320 Hwy 231 S
Troy, AL 36081-3000
Phone (334) 670-5430

1330 Hwy 231 S
Troy, AL 36081-3058
Phone (334) 670-5000

Hospital & facility affiliations

  • Troy Regional Medical Center Hospital, Troy, AL, CCN 010126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00007478ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Internal Medicine CurrentSince Jul 1, 1995 Accepting new patients
Troy Regional Physicians Inc CurrentSince Jul 1, 2017 Accepting new patients
Troy Hospital Health Care Authority Internal Medicine CurrentSince Nov 14, 2024 Accepting new patients
Houston County Healthcare Authority Internal Medicine CurrentSince Jul 1, 1995 Accepting new patients
Northern Alabama Physicians, LLP CurrentSince Dec 1, 2016 Accepting new patients
Troy Regional Physicians Inc CurrentSince Jul 1, 2017 Accepting new patients
Northern Alabama Physicians, LLP CurrentSince Dec 1, 2016 Accepting new patients
Northern Alabama Physicians, LLP Current Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

101 Professional Ln
Enterprise, AL 36330
Phone (334) 347-3404

400 N Edwards St
Enterprise, AL 36330
Phone (334) 347-0584

1320 Highway 231 S
Ste 1
Troy, AL 36081
Phone (334) 566-0546

1330 Highway 231 S
Troy, AL 36081
Phone (334) 370-5000

Interoperability endpoints

  • Direct secure messaging: bruce.williams.2@3503.direct.athenahealth.com
  • Direct secure messaging: bruce.williams.3@3503.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1417907791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E LEE ST",
            "address_2": "SUITE C",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302368",
            "telephone_number": "334-348-8818",
            "fax_number": "334-393-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E LEE ST",
            "address_2": "SUITE C",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302368",
            "telephone_number": "334-348-8818",
            "fax_number": "334-393-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00007478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000028379",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51028379",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.