NPIMap

Organization Active NPI

Williamson Eye Center

  • Ophthalmology Physician
  • Gonzales, LA
National Provider Identifier
1699812909
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD014115 Issued in LA
Legal business name
WILLIAMSON EYE CENTER
Practice address
2308 S Burnside Ave
Gonzales, LA 70737-4643
Phone
(225) 644-7525
Fax
(225) 647-3710
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Authorized official

Name
Charles H Williamson, M.D.NPI 1396740122
Title
Medical Director
Phone
(225) 924-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 773206T LA
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 830260T LA
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X MD014115 LA Primary

Addresses

Primary practice location

2308 S Burnside Ave
Gonzales, LA 70737-4643

Mailing address

2308 S Burnside Ave
Gonzales, LA 70737-4643
Phone (225) 644-7525

Other identifiers 1

IdentifierTypeStateIssuer
1797359MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000144 LA Part B Supplier - Clinic/Group Practice 9335131192 Receives reassigned benefits from 27 practitioners
7 other NPIs on this enrollment
Practice locations: Gonzales, LA; Zachary, LA; Saint Francisville, LA; New Roads, LA; Lutcher, LA; Denham Springs, LA; Baton Rouge, LA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2106955Williamson Eye Center2308 South Burnside Avenue, Gonzales, LA 70737Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
Williamson Eye Center Apmc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5233 Main St
Ste A
Zachary, LA 70791
Phone (225) 654-0090

5233 Main St
Zachary, LA 70791

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1699812909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 S BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374643",
            "telephone_number": "225-644-7525",
            "fax_number": "225-647-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 S BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374643",
            "telephone_number": "225-644-7525",
            "fax_number": "225-647-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "225-924-2020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "773206T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "830260T",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD014115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1797359",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.