Individual provider Active NPI

Ronald N. Williams, PH.D.

  • Clinical Neuropsychologist
  • Richmond, IN
National Provider Identifier
1457358392
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
20040664A Issued in IN
Practice address
2200 W Main St
Richmond, IN 47374-3882
Phone
(765) 973-9294
Fax
(765) 973-9233
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 20040664A IN Primary

Addresses

Primary practice location

2200 W Main St
Richmond, IN 47374-3882

Mailing address

2200 W Main St
Richmond, IN 47374-3882
Phone (765) 973-9294

Other practice location 1

11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845-1730
Phone (260) 460-3203

Other identifiers 2

IdentifierTypeStateIssuer
200040240MedicaidIN
860000042OtherINRR MEDICARE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000287 IN Practitioner - Clinical Psychologist 6002930864 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20040664AINMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Well Care Community Health, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Well Care Community Health, Inc. CurrentSince Aug 14, 2023 Accepting new patients

Locations

203 E Main St
Richmond, IN 47374
Phone (765) 973-9294

2200 W Main St
Richmond, IN 47374
Phone (765) 973-9294

Organizations & group practices 2

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1457358392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W MAIN ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473743882",
            "telephone_number": "765-973-9294",
            "fax_number": "765-973-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W MAIN ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473743882",
            "telephone_number": "765-973-9294",
            "fax_number": "765-973-9233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11104 Parkview Circle Dr",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451730",
            "country_code": "US",
            "telephone_number": "260-460-3203",
            "fax_number": "260-460-3130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RONALD",
        "middle_name": "N.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20040664A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200040240",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "860000042",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.