NPIMap

Organization Active NPI

Nathan D. Williamson, D.M.D. LLC

  • General Practice Dentistry
  • Columbia, IL
National Provider Identifier
1770010100
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019027747 Issued in IL
Legal business name
NATHAN D. WILLIAMSON, D.M.D. LLC
Practice address
240 Admiral Trost Rd
Columbia, IL 62236-2163
Phone
(618) 400-0550
Fax
(618) 400-0824
NPI assigned
May 16, 2017
Last updated
Dec 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Dr. Nathan David Williamson, DMDNPI 1871741454
Title
Dentist/Owner
Phone
(618) 281-7300

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019027747 IL Primary

Addresses

Primary practice location

240 Admiral Trost Rd
Columbia, IL 62236-2163

Mailing address

240 Admiral Trost Rd
Columbia, IL 62236-2163
Phone (618) 400-0550

Other identifiers 2

IdentifierTypeStateIssuer
1770010100OtherILNPI
1366864589OtherILDR. MATTHEW HAARMANN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1770010100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 ADMIRAL TROST RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362163",
            "telephone_number": "618-400-0550",
            "fax_number": "618-400-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 ADMIRAL TROST RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362163",
            "telephone_number": "618-400-0550",
            "fax_number": "618-400-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN D. WILLIAMSON, D.M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-16",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "618-281-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770010100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. MATTHEW HAARMANN",
            "identifier": "1366864589",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, IL

Sources for this page

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