Jeremy Shannon Williams, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

0101262111 Issued in VA

Practice address

3551 Roger Brooke Dr
Sammc, McHe-MDX, Internal Medicine Residency
Jbsa Ft Sam Houston, TX 78234-4504

Phone

(210) 916-8176

Fax

(210) 292-7868

NPI assigned

Jun 18, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Tennessee, HSC, College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaman Physician Services, PCGroup PAC ID 6406218130, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082
• Vanderbilt University Medical Center Hospital, Nashville, TN, CCN 440039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Beaman Physician Services, PC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1487342242
  Medicare reassignment Care Compare group NPD
• Saint Thomas Medical Partners

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Thomas West Hospital

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1629025648
  Care Compare affiliation
• Vanderbilt University Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1396882205
  Care Compare affiliation

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1619359304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "SAMMC, MCHE-MDX, INTERNAL MEDICINE RESIDENCY",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8176",
            "fax_number": "210-292-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "SAMMC, MCHE-MDX, INTERNAL MEDICINE RESIDENCY",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8176",
            "fax_number": "210-292-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JEREMY",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101262111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James White, MD
• Liam Patrick White, MD
• Aisa Wiberg, DO
• Jesse M Wickham, D.O.
• Joshua Michael Wilberg, MD
• Shelby Joan Williams
• Melina Catherine Williman, MD
• James Wesley Willis, CRNA
• Joe Ceaser Wilson, RN CASE MANAGER
• Mark Howard Wimmer, DNP

• General Practice Physician in Jbsa Ft Sam Houston, TX
• Providers in Jbsa Ft Sam Houston, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.