William Walton Mims III, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

16145 Issued in SC

Practice address

1700 Skylyn Dr
Spartanburg, SC 29307-1041

Phone

(864) 573-3777

Fax

(864) 573-3261

NPI assigned

Feb 17, 2006

Last updated

Apr 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Carolinas Pathology Group, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Spartanburg, SC
  • NPI 1730324583
  NPD (past)
• Spartanburg Pathology Consultants PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Spartanburg, SC
  • NPI 1720053309
  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1528033198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30637",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300637",
            "telephone_number": "704-973-5500",
            "fax_number": "704-973-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071041",
            "telephone_number": "864-573-3777",
            "fax_number": "864-573-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "WILLIAM",
        "middle_name": "WALTON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "16145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD",
            "identifier": "16145",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q50203",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD",
            "identifier": "9701066",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Nicole Mills, APRN
• Pamela Marie Mills
• William P. Mills Jr., DMD
• Abby Elizabeth Milner, MS, CCC-SLP
• Jonathan Lee Mims, DMD
• Mind Bloom LLC
• Veenna Minnal
• Nicholas Minner, DO
• Kimberly Lyn Minnick, LISW-CP, MAC
• Alyssa Boscia Minute, DNP

• Anatomic Pathology & Clinical Pathology Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Anatomic Pathology & Clinical Pathology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.