William L Webster, PA-C

Key facts

NPI

1467558320

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

101650 (NC)

Practice address

401 W Decatur St
Madison, NC 27025-1913

Phone

(336) 548-9618

Fax

(336) 548-4877

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 11, 2013.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1467558320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 COUNTRY OAKS LN",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273588129",
            "telephone_number": "336-951-0554",
            "fax_number": "336-548-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W DECATUR ST",
            "city": "MADISON",
            "state": "NC",
            "postal_code": "270251913",
            "telephone_number": "336-548-9618",
            "fax_number": "336-548-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2752584A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUE CROSS",
            "identifier": "1467558320",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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