NPIMap

Individual provider Active NPI

Jason Tyler Williams, D.O.

  • Pediatrics Physician
  • Pooler, GA
National Provider Identifier
1598029209
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
90053 Issued in GA
Practice address
1000 Towne Center Blvd Ste 1000B
Pooler, GA 31322-4129
Phone
(912) 353-7744
Fax
(912) 348-3589
NPI assigned
Jun 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 90053 GA Primary

Addresses

Primary practice location

1000 Towne Center Blvd Ste 1000B
Pooler, GA 31322-4129

Mailing address

2 Wheeler St
Savannah, GA 31405-5700
Phone (912) 353-7744

Other practice location 1

2 Wheeler St
Savannah, GA 31405-5700
Phone (912) 353-7744

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
90053GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Pediatrics Asheville PA Pediatrics PastSince Aug 1, 2020 Accepting new patients
Privia Medical Group of Georgia LLC Past Accepting new patients
Coastal Pediatrics, LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jason.tyler.williams.1@8042.direct.athenahealth.com
  • Direct secure messaging: jasonwilliams@bspa.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1598029209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WHEELER ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055700",
            "telephone_number": "912-353-7744",
            "fax_number": "912-355-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 1000B",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224129",
            "telephone_number": "912-353-7744",
            "fax_number": "912-348-3589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Wheeler St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314055700",
            "country_code": "US",
            "telephone_number": "912-353-7744",
            "fax_number": "912-355-9124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JASON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "90053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.