NPIMap

Organization Active NPI

David Thomas Williams

  • Optometrist
  • Lakewood, WA
National Provider Identifier
1508043019
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1624TX Issued in WA
Legal business name
DAVID THOMAS WILLIAMS
Practice address
9101 Bridgeport Way SW
Lakewood, WA 98499
Phone
(253) 588-2254
Fax
(253) 588-0545
NPI assigned
Jan 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Authorized official

Name
David Thomas Williams, OD
Title
Owner
Phone
(253) 588-2254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1624TX WA Primary

Addresses

Primary practice location

9101 Bridgeport Way SW
Lakewood, WA 98499

Mailing address

9101 Bridgeport Way SW
Lakewood, WA 98499
Phone (253) 588-2254

Other identifiers 1

IdentifierTypeStateIssuer
2130052MedicaidWA

Other names 1

  • Bridgeport Vision Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

9101 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 584-0858

9101 Bridgeport Way SW
Ste C
Tacoma, WA 98499
Phone (253) 584-2020

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1508043019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-588-2254",
            "fax_number": "253-588-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-588-2254",
            "fax_number": "253-588-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID THOMAS WILLIAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-588-2254",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1624TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2130052",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.