David Williams, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS6588 Issued in FL

Practice address

490 Centre Lake Dr NE
Suite 200
Palm Bay, FL 32907-1113

Phone

(800) 476-8646

Fax

(919) 382-3210

NPI assigned

Jun 1, 2005

Last updated

Apr 14, 2021By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Medfast Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1285735605
  Medicare reassignment Authorized official
• Melbourne Emergency Group, LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1932562915
  Medicare reassignment NPD
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Sebastian, FL
  • NPI 1376421479
  NPD Authorized official
• Medfast Family Physicians LLC

  • Primary Care Clinic/Center
  • Melbourne, FL
  • NPI 1174792048
  NPD (past) Authorized official
• Medfast Urgent Care Center, LLC

  • Urgent Care Clinic/Center
  • Titusville, FL
  • NPI 1962913681
  NPD (past) Authorized official
• Medfast Urgent Care Center, LLC

  • Urgent Care Clinic/Center
  • Cocoa Beach, FL
  • NPI 1972809275
  NPD (past) Authorized official
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Palm Bay, FL
  • NPI 1104555192
  NPD (past) Authorized official
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Port Orange, FL
  • NPI 1174262232
  NPD (past) Authorized official
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Merritt Island, FL
  • NPI 1235617432
  NPD (past) Authorized official
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Cocoa, FL
  • NPI 1316642788
  NPD (past) Authorized official
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Palm Bay, FL
  • NPI 1366710170
  NPD (past) Authorized official
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Titusville, FL
  • NPI 1417696584
  NPD (past) Authorized official

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1760484034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S TROPICAL TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524952",
            "telephone_number": "321-751-7222",
            "fax_number": "321-454-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 CENTRE LAKE DR NE",
            "address_2": "SUITE 200",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071113",
            "telephone_number": "800-476-8646",
            "fax_number": "919-382-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS6588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP # 34457",
            "identifier": "57352",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379858500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP # 45368",
            "identifier": "57352",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa D Wiles, LMHC
• Katie L Wilkerson, ARNP
• Elizabeth Williams-Henderson, APRN
• Barbara A Williams, M.S., LMHC
• Corey Williams
• Destyni Williams, OTR/L
• Maya Williams
• Monique S Williams, RBT
• Shelly R Williams, LISW
• Tiffanie Williams

• Emergency Medicine Physician in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.