Jack Williams, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

5955 Zeamer Ave
Jber, AK 99506-3702

Phone

(907) 580-0005

NPI assigned

Nov 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1629312988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACK",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-26",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micah Keith Watson, DO
• Jessica R White, LPN
• Matthew Christian White, DO
• Ashley Nicole-Inez Williams
• Audrea Doneta Williams, M.D.
• Ashley Nicole Wilson, RD
• Sean Miller Wilson
• Ashley N Wofford, LCSW
• Allison Nicole Womble, PHARM. D.
• Sarah Wood, DDS

• Independent Duty Medical Technicians in Jber, AK
• Providers in Jber, AK by specialty
• Independent Duty Medical Technicians in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.