Individual provider Active NPI

John I Williams, MD

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
National Provider Identifier
1427059682
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01045059A Issued in IN
Practice address
5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone
(260) 484-8551
Fax
(260) 482-5060
NPI assigned
Aug 9, 2005
Last updated
Oct 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01045059A IN Primary

Addresses

Primary practice location

5050 N Clinton St
Fort Wayne, IN 46825-5886

Mailing address

5052 N Clinton St
Fort Wayne, IN 46825-5822
Phone (260) 484-8551

Other practice location 1

11136 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 484-8551

Other practice location 2

1500 Provident Dr Ste B
Warsaw, IN 46580-3297
Phone (574) 269-8301

Other practice location 3

7920 W Jefferson Blvd
Fort Wayne, IN 46804-4168
Phone (260) 484-8551

Other identifiers 1

IdentifierTypeStateIssuer
200029200MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100929000644 IN Practitioner - Orthopedic Surgery 6305731969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Indiana University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics Northeast PCGroup PAC ID 9234024878, 80 clinicians

Practice addresses (Care Compare)

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone (260) 484-8551

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
85.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion230
Laminectomy or laminotomy (partial removal of spine bones)47
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045059AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics Northeast PC CurrentSince Aug 1, 1996 Accepting new patients
Orthopaedics Northeast PC Orthopaedic Surgery CurrentSince Aug 1, 1996 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

11136 Parkview Circle Dr
Fort Wayne, IN 46845

7920 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2668

5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551

5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203

1500 Provident Dr
Ste B
Warsaw, IN 46580
Phone (574) 269-8301

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1427059682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255886",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11136 Parkview Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451730",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Provident Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803297",
            "country_code": "US",
            "telephone_number": "574-269-8301",
            "fax_number": "574-269-8302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7920 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044168",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01045059A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200029200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.