Jeffrey R Williamson DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

JW011762 Issued in MI

Legal business name

JEFFREY R WILLIAMSON DO PC

Doing business as

Jeffrey R Williamson DO PC

Practice address

6785 Myers Lake Ave NE
Rockford, MI 49341

Phone

(616) 884-5191

Fax

(616) 884-5192

NPI assigned

Dec 15, 2006

Last updated

Jan 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy Jo Uecker

Title

Credentialing Manager

Phone

(269) 420-9404

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jeffrey R Williamson DO PC Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David M Keller II, DO

  • Family Medicine Physician
  • Rockford, MI
  • NPI 1578026969
  Medicare reassignment Care Compare group NPD
• Jeffrey R Williamson, DO

  • Family Medicine Physician
  • Rockford, MI
  • NPI 1881641165
  Medicare reassignment Care Compare group NPD
• Gretchen C Schumacher, CRNP

  • Family Nurse Practitioner
  • North Haven, ME
  • NPI 1235152935

  MI

  Medicare reassignment

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1750443750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "address_2": "6785 MYERS LAKE AVE NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493417416",
            "telephone_number": "616-884-5191",
            "fax_number": "616-884-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6785 MYERS LAKE AVE NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-884-5191",
            "fax_number": "616-884-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY R WILLIAMSON DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "UECKER",
        "authorized_official_first_name": "KATHY JO",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "269-420-9404"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JW011762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48109028",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey R Williamson DO PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jeffrey R Williamson DO PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Integrative Educational Partners, LLC
• Courtney Marie Jack, RN
• Chad J Jackson, OD
• Kristin M. Jacob, MD
• Erika Danielle Jaworowicz
• Sara Jensen, MA, LPC, LLMFT
• Jessica Burgess Counseling LLC
• Jessica Hoekstra LLC
• Susan Johnson, MD
• Douglas Carl Josephson, R.PH., FASCP

• Family Medicine Physician in Rockford, MI
• Providers in Rockford, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.