Individual provider Active NPI

Allison Nichelle Williams, MD

  • Family Medicine Physician
  • Crofton, MD
National Provider Identifier
1477545077
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0061041 Issued in MD
Practice address
1684 Village GRN Lowr Level
Crofton, MD 21114-2061
Phone
(410) 721-3822
Fax
(410) 451-0960
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0061041 MD Primary

Addresses

Primary practice location

1684 Village GRN Lowr Level
Crofton, MD 21114-2061

Mailing address

1684 Village GRN Lowr Level
Crofton, MD 21114-2059
Phone (410) 721-3822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615000190 MD Practitioner - Family Practice 7214920131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1684 Village GRN
Lowr Level
Crofton, MD 21114-2061
Phone (410) 721-3822

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061041MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Village Green Primary Care, LLC Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients

Locations

1684 Village Grn
Ste Ll
Crofton, MD 21114

1684 Village Grn
Crofton, MD 21114
Phone (410) 721-3822

1684 Village Grn
Lowr
Crofton, MD 21114
Phone (301) 675-6752

Interoperability endpoints

  • Direct secure messaging: allison.williams.1@33046.direct.athenahealth.com

Organizations & group practices 3

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1477545077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 VILLAGE GRN LOWR LEVEL",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142059",
            "telephone_number": "410-721-3822",
            "fax_number": "410-451-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 VILLAGE GRN LOWR LEVEL",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142061",
            "telephone_number": "410-721-3822",
            "fax_number": "410-451-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ALLISON",
        "middle_name": "NICHELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0061041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.