NPIMap

Individual provider Active NPI

Scott D. Williams, M.D.

  • Internal Medicine Physician
  • Massillon, OH
National Provider Identifier
1508862343
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-07-6997W Issued in OH
Practice address
2458 Lincoln Way E
Massillon, OH 44646-5085
Phone
(330) 837-1111
Fax
(330) 832-1341
NPI assigned
Jun 27, 2005
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-07-6997W OH Primary

Addresses

Primary practice location

2458 Lincoln Way E
Massillon, OH 44646-5085

Mailing address

2458 Lincoln Way E
Massillon, OH 44646-5085
Phone (330) 837-1111

Other identifiers 1

IdentifierTypeStateIssuer
2236440MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drwilliams@starkmedical.medentdirect.com Direct STARK MEDICAL SPECIALTIES, INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070111000044 OH Practitioner - Internal Medicine 6709886096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northeastern Ohio University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stark Medical Specialties, IncGroup PAC ID 5193702819, 3 clinicians

Practice addresses (Care Compare)

2458 Lincoln Way E
Massillon, OH 44646-5085
Phone 3308371111148

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stark Medical Specialties, Inc Internal Medicine CurrentSince Jan 10, 2007 Accepting new patients
Avis Leasing Co., LLC Past Accepting new patients
Aultman Hospital Past Accepting new patients

Locations

2458 Lincoln Way E
Massillon, OH 44646
Phone (330) 837-1111

323 Marion Ave NW
Ste 200
Massillon, OH 44646
Phone (330) 837-1111

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

Hospital & facility affiliations 7

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1508862343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446465085",
            "telephone_number": "330-837-1111",
            "fax_number": "330-832-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2458 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446465085",
            "telephone_number": "330-837-1111",
            "fax_number": "330-832-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-07-6997W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2236440",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drwilliams@starkmedical.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "STARK MEDICAL SPECIALTIES, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2458 Lincoln Way E",
            "city": "Massillon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446465085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.