Samuel Leviticus Williams III, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D0076276 Issued in MD

Practice address

1111 Washington Blvd
Baltimore, MD 21230-1824

Phone

(410) 383-8300

Fax

(410) 383-3160

NPI assigned

May 31, 2007

Last updated

Nov 27, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Psychiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marys Center for Maternal and Child Care IncGroup PAC ID 5092798298, 55 clinicians

Practice addresses (Care Compare)

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.

• Mary's Center for Maternal and Child Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1962520288
  Medicare reassignment Care Compare group NPD
• Bloom Health LLC

  • Psychiatry Physician
  • West Friendship, MD
  • NPI 1154187193
  NPD Authorized official
• Mary's Center for Maternal and Child Care Inc

  • Federally Qualified Health Center (FQHC)
  • Silver Spring, MD
  • NPI 1174011563
  NPD
• Marys Center for Maternal and Child Care Inc

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1831635986
  NPD

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1659572956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 WASHINGTON BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212301824",
            "telephone_number": "410-383-8300",
            "fax_number": "410-383-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 WASHINGTON BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212301824",
            "telephone_number": "410-383-8300",
            "fax_number": "410-383-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SAMUEL",
        "middle_name": "LEVITICUS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0076276",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0076276",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123305000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richelle T Williams, M.D.
• Robert Charles Williams, LGPC
• Ronald Williams
• Ruth Leeanna Williams
• Sade Williams
• Sarah Ray Williams, M.D.
• Shakia Williams
• Shamree Lynn Williams
• Shanell Nikita Williams
• Shaniece Williams

• Psychiatry Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.