Individual provider Active NPI

Christopher Stiles Williamson, NP

  • Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1467209940
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
GAA-NP002253 Issued in GA
Practice address
775 Poplar Rd Ste 160a
Newnan, GA 30265-8302
Phone
(770) 400-4630
NPI assigned
May 2, 2024
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X GAA-NP002253 GA
Nurse Practitioner 363L00000X GAA-NP002253 GA Primary

Addresses

Primary practice location

775 Poplar Rd Ste 160a
Newnan, GA 30265-8302

Mailing address

66649 Highway 22
Roanoke, AL 36274-3651

Other practice location 1

775 Poplar Rd Ste 160B
Newnan, GA 30265-8302
Phone (770) 400-4630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719000969 GA Practitioner - Nurse Practitioner 3577009117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

775 Poplar Rd
Suite 160
Newnan, GA 30265-8300
Phone (770) 400-4630

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP002253GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Jul 8, 2024 Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

775 Poplar Rd
Ste 160
Newnan, GA 30265
Phone (770) 400-4630

775 Poplar Rd
Ste 160A
Newnan, GA 30265
Phone (770) 400-4630

775 Poplar Rd
Ste 160B
Newnan, GA 30265
Phone (770) 400-4630

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

Hospital & facility affiliations 2

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": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1467209940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66649 HIGHWAY 22",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362743651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD STE 160A",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658302",
            "telephone_number": "770-400-4630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Poplar Rd Ste 160B",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302658302",
            "country_code": "US",
            "telephone_number": "770-400-4630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "STILES",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "GAA-NP002253",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP002253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.