Individual provider Active NPI

William Stephen Hutcheson, PA-C

  • Physician Assistant
  • Waycross, GA
National Provider Identifier
1629283023
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4140 Issued in GA
Practice address
1908 Alice St
Waycross, GA 31501-6208
Phone
(912) 338-6010
Fax
(912) 287-2796
NPI assigned
May 11, 2007
Last updated
Mar 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4140 GA Primary

Addresses

Primary practice location

1908 Alice St
Waycross, GA 31501-6208

Mailing address

PO Box 173
Waycross, GA 31502-0173
Phone (912) 283-8444

Other identifiers 1

IdentifierTypeStateIssuer
981425965BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060410000365 GA Practitioner - Physician Assistant 2264441856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians
Memorial Satilla Specialists, LLCGroup PAC ID 5991074957, 19 clinicians

Practice addresses (Care Compare)

111 Colonial Way
Jesup, GA 31545-0130
Phone (912) 588-9110

1481 Hwy 40 E
Kingsland, GA 31548-6507
Phone (912) 576-6865

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

305 Pineview Dr
Waycross, GA 31501-5229
Phone (912) 283-8444

316 Shirley Ave
Douglas, GA 31533-2332
Phone (912) 383-0815

3200 N Ashley St
Suite C
Valdosta, GA 31602-5911
Phone (229) 671-9160

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2804
Phone (770) 222-8900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System in Waycross, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.hutcheson@hca5.eclinicaldirectplus.com

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1629283023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315020173",
            "telephone_number": "912-283-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016208",
            "telephone_number": "912-338-6010",
            "fax_number": "912-287-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHESON",
        "first_name": "WILLIAM",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "4140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "981425965B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.