Individual provider Active NPI

Sean A Williams, D.C.

  • Chiropractor
  • Ocean City, MD
National Provider Identifier
1508903956
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01779 Issued in MD
Practice address
12417 Ocean Gtwy
Unit 2a
Ocean City, MD 21842-9521
Phone
(410) 213-8787
Fax
(410) 213-1234
NPI assigned
Feb 1, 2007
Last updated
Mar 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S01779 MD Primary

Addresses

Primary practice location

12417 Ocean Gtwy
Unit 2a
Ocean City, MD 21842-9521

Mailing address

12417 Ocean Gtwy
Unit 2a
Ocean City, MD 21842-9521
Phone (410) 213-8787

Other identifiers 3

IdentifierTypeStateIssuer
61990802OtherMDBLUE CROSS RENDERING ID
J034-0001OtherMDBLUE CHOICE ID
497ACOOtherMDMD BC BS PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000413 MD Practitioner - Chiropractic 0749268860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Chiropractic CenterGroup PAC ID 4981682002, 2 clinicians

Practice addresses (Care Compare)

12417 Ocean Gtwy
Suite 2a
Ocean City, MD 21842-9522
Phone (410) 213-1233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S01779MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Zia-Shakeri Chiropractic Clinic, PA CurrentSince Nov 6, 2011 Accepting new patients
Coastal Chiropractic Center Chiropractor CurrentSince Jan 28, 2004 Accepting new patients
Morrison Chiropractic & Wellness Center, P.a. PastSince Jan 9, 2001 Accepting new patients

Locations

12417 Ocean Gtwy
Ste 2
Ocean City, MD 21842
Phone (410) 213-1233

12417 Ocean Gtwy
Ste 2A
Ocean City, MD 21842
Phone (410) 213-1233

12417 Ocean Gtwy
Unit 2A
Ocean City, MD 21842
Phone (410) 213-8787

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1508903956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 OCEAN GTWY",
            "address_2": "UNIT 2A",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429521",
            "telephone_number": "410-213-8787",
            "fax_number": "410-213-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 OCEAN GTWY",
            "address_2": "UNIT 2A",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429521",
            "telephone_number": "410-213-8787",
            "fax_number": "410-213-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SEAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS RENDERING ID",
            "identifier": "61990802",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE ID",
            "identifier": "J034-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD BC BS PROVIDER ID",
            "identifier": "497ACO",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.