Mark Bascom Williamson, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

97-00161 Issued in NC

Practice address

218 Old Mocksville Rd
Statesville, NC 28625-1930

Phone

(704) 838-7091

Fax

(704) 838-7093

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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 NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: markwilliamson@markwilliamsonmd.kareodirect.com

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1679685929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286870746",
            "telephone_number": "704-838-7091",
            "fax_number": "704-838-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-838-7091",
            "fax_number": "704-838-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MARK",
        "middle_name": "BASCOM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "97-00161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00298227",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891022N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nan Plyler Williams, OTR/L
• Sarah Johnson Williams, MA/EDS, LPC, NCC
• Stacie Ann Williams, OD
• Theresa Miller Williams, FNP-C
• Trinity Williams, LPN
• Exavier Danielle Wilson, LCSWA
• Gidget J. Wilson, RN
• Hillary Wilson
• Shelby Wilson
• Wayne Douglas Wilson, D.MIN.

• Orthopaedic Surgery Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Orthopaedic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.