Individual provider Active NPI

Robert Davis Williams, M.D.

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1619028404
Registry record updated Jan 4, 2010
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Jan 20, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME305182 Issued in FL
Practice address
1597 Harrington Park Dr
Jacksonville, FL 32225-4919
Phone
(304) 633-5595
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME305182 FL Primary
Emergency Medicine Physician 207P00000X MD29580 AL
Emergency Medicine Physician 207P00000X 062795 GA
Emergency Medicine Physician 207P00000X MD203401 LA
Emergency Medicine Physician 207P00000X 20885 MS

Addresses

Primary practice location

1597 Harrington Park Dr
Jacksonville, FL 32225-4919

Mailing address

1597 Harrington Park Dr
Jacksonville, FL 32225-4919
Phone (304) 633-5595

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME305182FLMDEmergency Medicine Physician
062795GAMDEmergency Medicine Physician
MD203401LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine Past Accepting new patients
Acs Emergency Services of Mississippi Professional Association Emergency Medicine PastSince Sep 20, 2020 Accepting new patients
Emergency Services of Zephyrhills PA Emergency Medicine Past Accepting new patients

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1619028404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1597 HARRINGTON PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254919",
            "telephone_number": "304-633-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1597 HARRINGTON PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254919",
            "telephone_number": "304-633-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERT",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME305182",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD29580",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "062795",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD203401",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "20885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.