Randall Williams, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

39753 Issued in CO

Practice address

4021 Avenue B
Scottsbluff, NE 69361-4602

Phone

(308) 630-1919

NPI assigned

Aug 10, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of Texas Medical School at Houston, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Pathology Consultants, PCGroup PAC ID 9032188362, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regional West Medical Center Hospital, Scottsbluff, NE, CCN 280061

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Pathology Consultants, PC

  • Clinical Medical Laboratory
  • Scottsbluff, NE
  • NPI 1588674980
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regional West Medical Center

  • General Acute Care Hospital
  • Scottsbluff, NE
  • NPI 1639101199
  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1538170238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1886",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693611886",
            "telephone_number": "308-630-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 AVENUE B",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614602",
            "telephone_number": "308-630-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "39753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00386100",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30773",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark L Willats, DPM
• Carrie Williams
• Daniel C Williams, M.D.
• Linda Williams
• Nancy Lynn Williams
• Samantha Williams
• Wendy Williams, M.D.
• Wills Chiropractic Clinic, P.C.
• Blake Tyler Wills
• Daryl D Wills, D.C.

• Anatomic Pathology & Clinical Pathology Physician in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.