Individual provider Active NPI

David Robert Williams Sr.

  • Pediatrics Physician
  • Thomasville, NC
National Provider Identifier
1619945029
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
13953 Issued in NC
Practice address
200 Arthur Dr
Thomasville, NC 27360-6275
Phone
(336) 475-2348
Fax
(336) 475-2100
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13953 NC Primary

Addresses

Primary practice location

200 Arthur Dr
Thomasville, NC 27360-6275

Mailing address

200 Arthur Dr
Thomasville, NC 27360-6275
Phone (336) 475-2348

Other identifiers 1

IdentifierTypeStateIssuer
8987679MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20100622000638 NC Practitioner - Pediatric Medicine 6103955703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13953NCMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomasville-Archdale Pediatrics, PLLC Pediatrics CurrentSince May 1, 2016 Accepting new patients
Thomasville/Archdale Pediatrics PLLC Past Accepting new patients

Locations

200 Arthur Dr
Thomasville, NC 27360
Phone (336) 475-2348

Organizations & group practices 2

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1619945029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ARTHUR DR",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273606275",
            "telephone_number": "336-475-2348",
            "fax_number": "336-475-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARTHUR DR",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273606275",
            "telephone_number": "336-475-2348",
            "fax_number": "336-475-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "13953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8987679",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.