Organization Active NPI

Ronald F. Williamson M.D., P.C.

  • Family Medicine Physician
  • Grosse Pointe Farms, MI
National Provider Identifier
1699893453
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RONALD F. WILLIAMSON M.D., P.C.
Practice address
18348 Mack Ave
Grosse Pointe Farms, MI 48236-3219
Phone
(313) 862-3104
Fax
(313) 862-1290
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ronald Williamson Sr., M.D.NPI 1659482826
Title
Owner Family Physician
Phone
(313) 862-3104

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

18348 Mack Ave
Grosse Pointe Farms, MI 48236-3219

Mailing address

17130 Schaefer Hwy
Detroit, MI 48235-4131
Phone (313) 862-3104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060113000824 MI Part B Supplier - Clinic/Group Practice 0648294850 Receives reassigned benefits from 3 practitioners
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Locations

17130 Schaefer Hwy
Detroit, MI 48235
Phone (313) 862-3104

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699893453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17130 SCHAEFER HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482354131",
            "telephone_number": "313-862-3104",
            "fax_number": "313-862-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18348 MACK AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363219",
            "telephone_number": "313-862-3104",
            "fax_number": "313-862-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD F. WILLIAMSON M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "313-862-3104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.