Summer Williamson

Primary specialty

OptometristTaxonomy code 152W00000X

License

2011023816 Issued in MO

Practice address

1090 Arnold Dr
Little Rock Air Force Base, AR 72099-4933

Phone

(501) 987-8702

NPI assigned

Sep 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: summer.williamson.p1@direct.jordanvalley.nextgenshare.com

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.

• Vision Gallery 417 LLC

  • Optometrist
  • Springfield, MO
  • NPI 1144045808
  Medicare reassignment NPD Authorized official
• Advocates for a Healthy Community, Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Springfield, MO
  • NPI 1558303057
  Medicare reassignment NPD
• Advocates for a Healthy Community Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Buffalo, MO
  • NPI 1750179610
  NPD

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1447400668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N SUMMIT DR",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720239187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AIR FORCE BASE",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "SUMMER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011023816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Jean Taylor, LCSW
• Jessika Twin Taylor, RDH
• Nathaniel Trona, MD
• Kevin Weaver Jr., M.D.
• Jessica L White
• Kimberly D Yada, MSW, LCSW

• Optometrist in Little Rock Air Force Base, AR
• Providers in Little Rock Air Force Base, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.