Individual provider Active NPI

Bryan Christopher Williams, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Eugene, OR
National Provider Identifier
1457699142
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
189318 Issued in OR
Practice address
330 S Garden Way Ste 140
Eugene, OR 97401
Phone
(541) 686-9750
Fax
(541) 485-5034
NPI assigned
Jan 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 189318 OR Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D10901 OR

Addresses

Primary practice location

330 S Garden Way Ste 140
Eugene, OR 97401

Mailing address

330 S Garden Way Ste 140
Eugene, OR 97401-8181
Phone (541) 686-9750

Other identifiers 2

IdentifierTypeStateIssuer
188954OtherORMD LICENSE
D10901OtherORDMD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20190827001798 OR Practitioner - Oral Surgery 3577795541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Nebraska College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Oral and Implant Surgeons PCGroup PAC ID 9537054580, 2 clinicians

Practice addresses (Care Compare)

330 S Garden Way
Suite 140
Eugene, OR 97401-8181
Phone (541) 686-9750

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D10901ORMDOral and Maxillofacial Surgery (Dentist)
189318ORMDOral & Maxillofacial Surgery (D.M.D.)

Interoperability endpoints

  • Direct secure messaging: bwilli04@yourcarecommunity.org

Organizations & group practices 1

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": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1457699142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY STE 140",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018181",
            "telephone_number": "541-686-9750",
            "fax_number": "402-559-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY STE 140",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-686-9750",
            "fax_number": "541-485-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRYAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "189318",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D10901",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "188954",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMD LICENSE",
            "identifier": "D10901",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.