Individual provider Active NPI

Gregory L. Williams, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1679627707
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH004212 Issued in FL
Practice address
4602 N Nebraska Ave
Tampa, FL 33603-4014
Phone
(813) 237-3791
Fax
(813) 237-3792
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH004212 FL Primary

Addresses

Primary practice location

4602 N Nebraska Ave
Tampa, FL 33603-4014

Mailing address

4602 N Nebraska Ave
Tampa, FL 33603-4014
Phone (813) 237-3791

Other identifiers 1

IdentifierTypeStateIssuer
054896100MedicaidFL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew W. Godwin, D.C., P.a. Chiropractor CurrentSince Mar 22, 2020 Accepting new patients

Locations

5346 8th St
Zephyrhills, FL 33542
Phone (813) 782-1316

Organizations & group practices 1

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1679627707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336034014",
            "telephone_number": "813-237-3791",
            "fax_number": "813-237-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336034014",
            "telephone_number": "813-237-3791",
            "fax_number": "813-237-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GREGORY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH004212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054896100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.