Individual provider Active NPI

John Charles Williams, DPM

  • Foot & Ankle Surgery Podiatrist
  • Redding, CA
National Provider Identifier
1770548562
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00E20300 Issued in CA
Practice address
1950 Rosaline Ave Ste F
Redding, CA 96001-2543
Phone
(530) 244-3338
Fax
(530) 244-3342
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00E20300 CA Primary

Addresses

Primary practice location

1950 Rosaline Ave Ste F
Redding, CA 96001-2543

Mailing address

1950 Rosaline Ave Ste F
Redding, CA 96001-2543
Phone (530) 244-3338

Other identifiers 1

IdentifierTypeStateIssuer
4044019MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000700 CA Order and Referring Only - PodiatryPractitioner - Podiatry 9436332244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00E20300CAMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770548562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 ROSALINE AVE STE F",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012543",
            "telephone_number": "530-244-3338",
            "fax_number": "530-244-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ROSALINE AVE STE F",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012543",
            "telephone_number": "530-244-3338",
            "fax_number": "530-244-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "00E20300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4044019",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.