William Pollock Barley Jr., M.D.
Individual provider Active NPI Family Medicine Physician · Placerville, CA
NPI 1619062007 · NPPES record last updated Feb 24, 2009
Key facts
- NPI
- 1619062007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G72071 (CA)
- Practice address
- 1004 Fowler Way
Suite #1
Placerville, CA 95667 - Phone
- (530) 626-8003
- Fax
- (530) 626-8082
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G72071 | CA | MD | Family Medicine Physician |
Interoperability endpoints
- william.barley.1@16983.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G72071 | CA | Yes |
Addresses
Primary practice location
1004 Fowler Way
Suite #1
Placerville, CA 95667
Mailing address
1004 Fowler Way
Suite #1
Placerville, CA 95667
Phone (530) 626-8003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94-3407141 | Other | CA | TAX ID |
| 00G720710 | Other | CA | MEDI-CAL NUMBER |
Other providers in Placerville, CA
- Barba & Associates, Family Medicine, Inc.
- Peter Andrew Barba
- Angela Carol Barber
- Barinderpal Cheema DDS Inc
- Susie Barineau
- Ashley Barnes-Brown
- Bradley Barnhill
- Rebecca Marie Barrington
- Cecilia Barron
- Christine Barton
All providers in Placerville, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.