Individual provider Active NPI

William J Williams, D.O.

  • Internal Medicine Physician
  • Jefferson City, TN
National Provider Identifier
1508896952
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
962 Issued in TN
Practice address
1526 Meadow Spring Dr
Jefferson City, TN 37760-2041
Phone
(865) 475-4988
Fax
(865) 475-4350
NPI assigned
Jul 3, 2006
Last updated
Nov 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 962 TN Primary
Pediatrics Physician 208000000X 962 TN

Addresses

Primary practice location

1526 Meadow Spring Dr
Jefferson City, TN 37760-2041

Mailing address

1526 Meadow Spring Dr
Jefferson City, TN 37760-2041
Phone (865) 475-4988

Other identifiers 2

IdentifierTypeStateIssuer
33031801MedicaidTN
5167078OtherTNAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
962TNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeway Emergency Physicians, LLC Past Accepting new patients
William J Williams DO PC PastSince Sep 1, 2002 Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Morristown Clinic Corp Internal Medicine PastSince Jul 29, 2015 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1508896952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 MEADOW SPRING DR",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602041",
            "telephone_number": "865-475-4988",
            "fax_number": "865-475-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 MEADOW SPRING DR",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602041",
            "telephone_number": "865-475-4988",
            "fax_number": "865-475-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "962",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "962",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33031801",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5167078",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.