William R Witham, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

L8231 Issued in TX

Practice address

1325 Pennsylvania Ave
Suite 200
Fort Worth, TX 76104-2158

Phone

(817) 332-9957

Fax

(817) 336-3130

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

General SurgeryAlso: Peripheral Vascular Disease

Education

Texas Tech University Health Science Center School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wwitham225131@christushealth.direct-ci.net

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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Texas Health Care, P.L.L.C.

  • Obstetrics & Gynecology Physician
  • Willow Park, TX
  • NPI 1073679379
  NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352

  Surgery

  NPD

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1447201157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042158",
            "telephone_number": "817-332-9957",
            "fax_number": "817-336-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042158",
            "telephone_number": "817-332-9957",
            "fax_number": "817-336-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Houston St Ste 270",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028367",
            "country_code": "US",
            "telephone_number": "903-606-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHAM",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "L8231",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L8231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176760002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTC - BCBS",
            "identifier": "1D7580",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176760001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Wise, PA
• Alyson Wiseman
• Cymone Wisemon
• Sheryl Sabillo Wiser, M.D.
• Wish Mema
• Erika Elizabeth Withers
• Rayshad Withrow, OTR
• James K Witschy, MD
• Haylee Witt, PMHNP-BC
• Stefan Witt

• Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.