Active NPI
Nathan A Williamson, MD
- Family Medicine Physician
- Laurel, MS
National Provider Identifier
1679585673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 09662
- Practice address
- 1515 Jefferson St
Laurel, MS 39440-4244 - Phone
- (601) 425-4893
- Fax
- (601) 428-8633
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 09662 | MS | Primary |
Addresses
Primary practice location
1515 Jefferson St
Laurel, MS 39440-4244
Mailing address
1515 Jefferson St
Laurel, MS 39440-4244
Phone (601) 425-4893
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09552566 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09662 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Intermed Corporation | Family Medicine | Past | Accepting new patients |
| Bama Urgent Medicine, Inc | Family Medicine | Past | Accepting new patients |
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": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679585673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 JEFFERSON ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394404244",
"telephone_number": "601-425-4893",
"fax_number": "601-428-8633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 JEFFERSON ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394404244",
"telephone_number": "601-425-4893",
"fax_number": "601-428-8633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "NATHAN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "09662",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09552566",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.