Samuel Williams, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC968 Issued in FL

Practice address

112 E Dixie Ave
Leesburg, FL 34748-6350

Phone

(352) 787-1956

Fax

(352) 365-6690

NPI assigned

Sep 20, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Coren Eye Group PLLC

  • Optometrist
  • Leesburg, FL
  • NPI 1588182562
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1720186117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486350",
            "telephone_number": "352-787-1956",
            "fax_number": "352-365-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486350",
            "telephone_number": "352-787-1956",
            "fax_number": "352-365-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SAMUEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078718300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sadie Wilkins
• Ashlee Williams
• Cheryl Williams, OWNER
• Connie Renea Williams, ARNP-BC, MSN, BSN
• Renee Gabriel Williams, APRN
• Tabitha Williams
• Zena Tamara Williams
• Kaneitra L. Williamson, PA-C
• Corey Kareen Wilson
• Courtney Wilson

• Optometrist in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.