NPIMap

Individual provider Active NPI

Reatha M Williams, DO

  • Surgery Physician
  • Lafayette, LA
National Provider Identifier
1740236504
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DO.000148 Issued in LA
Practice address
5000 Ambassador Caffery Pkwy BLDG 10
Lafayette, LA 70508-6984
Phone
(337) 470-7801
Fax
(337) 470-7800
NPI assigned
May 25, 2006
Last updated
May 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS 8472 FL
Surgery Physician 208600000X DO.000148 LA Primary

Addresses

Primary practice location

5000 Ambassador Caffery Pkwy BLDG 10
Lafayette, LA 70508-6984

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other practice location 1

4704 Ambassador Caffery Pkwy Ste 301
Lafayette, LA 70508-6908
Phone (337) 443-6888

Other practice location 2

4630 Ambassador Caffery Pkwy
Suite 308
Lafayette, LA 70508-6949
Phone (337) 989-8770

Other identifiers 2

IdentifierTypeStateIssuer
1369357MedicaidLA
264585801MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rwilliams15766@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS 8472FLMDSurgery Physician
DO.000148LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart and Family Health Institute of Port St Lucie Past Accepting new patients
St Lucie Medical Specialists LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1740236504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY BLDG 10",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-470-7801",
            "fax_number": "337-470-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4704 Ambassador Caffery Pkwy Ste 301",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086908",
            "country_code": "US",
            "telephone_number": "337-443-6888",
            "fax_number": "337-443-6899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4630 Ambassador Caffery Pkwy",
            "address_2": "Suite 308",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086949",
            "country_code": "US",
            "telephone_number": "337-989-8770",
            "fax_number": "337-989-8768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "REATHA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS 8472",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "DO.000148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1369357",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264585801",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwilliams15766@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rwilliams15766@direct.casso.us.com",
            "address_1": "5000 Ambassador Caffery Pkwy Bldg 10",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5000 Ambassador Caffery Pkwy Bldg 10",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.