Active NPI
Charles Ody Williams, RPA-RA(CBRPA), RT(R)
- Pulmonary Function Technologist Certified Respiratory Therapist
- Atlanta, GA
National Provider Identifier
1659577708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Function Technologist Certified Respiratory Therapist
- Practice address
- 1365 Clifton Rd NE # C430
Atlanta, GA 30322-1013 - Phone
- (404) 712-7034
- Fax
- (404) 727-3377
- NPI assigned
- Jun 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular-Interventional Technology Radiologic Technologist | 2471C1101X | ARRT 053679 | MN | |
| Radiography Radiologic Technologist | 2471C3402X | ARRT 053679 | MN | |
| Vascular-Interventional Technology Radiologic Technologist | 2471V0106X | ARRT 053679 | MN | |
| Cardiac-Interventional Technology Radiologic Technologist | 2471C1106X | ARRT 053679 | MN | |
| Cardiovascular Invasive Specialist/Technologist | 246XC2901X | CCI 00040350 | NC | |
| Cardiology Technician | 246W00000X | CCI 00040350 | NC | |
| Medical Physician Assistant | 363AM0700X | CBRPA 03GA1071 RPA | UT | |
| Pulmonary Function Technologist Certified Respiratory Therapist | 2278P1006X | MT | Primary |
Addresses
Primary practice location
1365 Clifton Rd NE # C430
Atlanta, GA 30322-1013
Mailing address
1801 Womack Rd
Atlanta, GA 30338-5142
Phone (770) 390-0620
Other names 1
- Mr. Chuck Williams
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CCI 00040350 | NC | MD | Cardiovascular Invasive Specialist/Technologist |
| ARRT 053679 | MN | MD | Cardiovascular-Interventional Technology Radiologic Technologist |
| CBRPA 03GA1071 RPA | UT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1659577708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 WOMACK RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303385142",
"telephone_number": "770-390-0620",
"fax_number": "770-390-0620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE # C430",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "404-712-7034",
"fax_number": "404-727-3377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CHARLES",
"middle_name": "ODY",
"name_prefix": "Mr.",
"credential": "RPA-RA(CBRPA), RT(R)",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-25",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "2471C1101X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Cardiovascular-Interventional Technology",
"state": "MN",
"license": "ARRT 053679",
"primary": false
},
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "MN",
"license": "ARRT 053679",
"primary": false
},
{
"code": "2471V0106X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Vascular-Interventional Technology",
"state": "MN",
"license": "ARRT 053679",
"primary": false
},
{
"code": "2471C1106X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Cardiac-Interventional Technology",
"state": "MN",
"license": "ARRT 053679",
"primary": false
},
{
"code": "246XC2901X",
"taxonomy_group": "",
"desc": "Specialist/Technologist Cardiovascular, Cardiovascular Invasive Specialist",
"state": "NC",
"license": "CCI 00040350",
"primary": false
},
{
"code": "246W00000X",
"taxonomy_group": "",
"desc": "Technician, Cardiology",
"state": "NC",
"license": "CCI 00040350",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": "CBRPA 03GA1071 RPA",
"primary": false
},
{
"code": "2278P1006X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified, Pulmonary Function Technologist",
"state": "MT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHUCK",
"last_name": "WILLIAMS",
"prefix": "MR.",
"credential": "RPA-RA(CBRPA), RT(R)",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.