Active NPI
Robert Davis Williams, M.D.
- Emergency Medicine Physician
- Jacksonville, FL
National Provider Identifier
1619028404
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.
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME305182
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME305182 | FL | MD | Emergency Medicine Physician |
| 062795 | GA | MD | Emergency Medicine Physician |
| MD203401 | LA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acs Primary Care Physicians - Southeast PC | Emergency Medicine | Past | Accepting new patients |
| Acs Emergency Services of Mississippi Professional Association | Emergency Medicine | Past | 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.
-
- Emergency Medicine Physician
- Dade City, FL
- NPI 1265631097
-
- Emergency Medicine Physician
- Cleveland, MS
- NPI 1396996997
-
- Emergency Medicine Physician
- Myrtle Beach, SC
- NPI 1861430555
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.