John Bruce Williams, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

WA 00026409 Issued in WA

Practice address

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805

Phone

(503) 472-6161

Fax

(503) 434-6290

NPI assigned

Apr 25, 2006

Last updated

May 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Oregon Health & Sciences Univ School of Dentistry, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physicians Medical Center P CGroup PAC ID 6305832890, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
• Amedisys Home Health Care Home health agency, Salem, OR, CCN 387136
• Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physicians Medical Center P C

  • General Practice Physician
  • McMinnville, OR
  • NPI 1326097122
  Medicare reassignment Care Compare group NPD
• Physicians Medical Center, P C

  dba Physicians Medical Center, Lab

  • Clinical Medical Laboratory
  • McMinnville, OR
  • NPI 1821035841
  NPD

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

• First Call Home Health Agency, LLC

  • Home Health Agency
  • Salem, OR
  • NPI 1740260801
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation
• Willamette Valley Medical Center LLC

  dba Willamette Valley Medical Center

  • General Acute Care Hospital
  • McMinnville, OR
  • NPI 1346269982
  Care Compare affiliation

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1619933934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-6290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21616 76th Ave W",
            "address_2": "#208",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980267512",
            "country_code": "US",
            "telephone_number": "425-778-2499",
            "fax_number": "425-776-0197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD 26409",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "WA 00026409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1075928",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1075928",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willamette Valley Medical Center LLC (Willamette Valley Medical Center)
• Willamette Valley Medical Center LLC (Senior Behavioral Health Unit)
• Willamette Valley Orthopaedic Surgery
• Kaitlyn Willcuts
• Claudia L Williams-Mara, LPC
• Waverly Tyrese Williams
• Theodore J Williamson, M.D.
• Carmen Dolores Wilson
• Jason Edward Wilson
• Roxanne Franklin Wilson, BA, QMHA, PSS

• Geriatric Medicine (Internal Medicine) Physician in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Geriatric Medicine (Internal Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.