Active NPI
Thomas Ralph Williams IV, D.O.
- Emergency Medicine Physician
- Tacoma, WA
National Provider Identifier
1558488445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- OP60080001
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-3004 - Phone
- (253) 968-2252
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | OP60080001 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-3004
Mailing address
8507 23Rd Street CT W
University Place, WA 98466-2800
Phone (253) 227-6509
Other practice location 1
11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 985-8700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OP60080001 | Other | WA | WASHINGTON STATE |
| 0102202983 | Other | VA | MEDICAL LICENSE |
| 12308423 | Other | CAQH | |
| 5101017126 | Other | MI | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
Locations
888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115
1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101
11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711
Interoperability endpoints
- twilliams10045@fhsce.catholichealth.net
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Arlington, WA
- NPI 1235172370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1558488445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8507 23RD STREET CT W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984662800",
"telephone_number": "253-227-6509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984313004",
"telephone_number": "253-968-2252"
}
],
"practiceLocations": [
{
"address_1": "11315 Bridgeport Way SW",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "WA",
"postal_code": "984993004",
"country_code": "US",
"telephone_number": "253-985-8700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "THOMAS",
"middle_name": "RALPH",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "OP60080001",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE",
"identifier": "OP60080001",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "0102202983",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12308423",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "5101017126",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.