Roger Alan Williams, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY001108 Issued in GA

Practice address

655 First Street
Macon, GA 31201

Phone

(478) 301-5930

Fax

(478) 301-5932

NPI assigned

Oct 19, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: roger.williams.1@8042.direct.athenahealth.com

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment Care Compare group NPD
• The Corporation of Mercer University

  • Family Medicine Physician
  • Macon, GA
  • NPI 1174693162
  Medicare reassignment NPD
• Movement Sports Physical Therapy, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1902144793
  NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD
• The Corporation of Mercer University

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1841171998
  NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1679655922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 COLLEGE ST",
            "address_2": "A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312070001",
            "telephone_number": "478-301-5930",
            "fax_number": "478-301-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 FIRST STREET",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-301-5930",
            "fax_number": "478-301-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROGER",
        "middle_name": "ALAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY001108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "680006605",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000342933A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Reese Williams Jr., MD
• Lakeshia Shaun Williams, LPC
• Lydia Williams
• Margaret L Williams, LPC
• Miesha Leigh Williams
• Sam Oliver Williams, DMD
• Selena Burns Williams, DOCTOR OF PHARMACY
• Shamita Morgan Williams, M.D.
• Shamyn Williams, PTA
• Shania Williams

• Clinical Psychologist in Macon, GA
• Providers in Macon, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.