Individual provider Active NPI

Roschel Williams, MD

  • Family Medicine Physician
  • Conyers, GA
National Provider Identifier
1780247353
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
98391 Issued in GA
Practice address
1910 Highway 20 SE Ste 270
Conyers, GA 30013-2082
Phone
(770) 922-3522
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 319235 NY
Family Medicine Physician 207Q00000X 98391 GA Primary

Addresses

Primary practice location

1910 Highway 20 SE Ste 270
Conyers, GA 30013-2082

Mailing address

396 Broadway
Kingston, NY 12401-4626
Phone (845) 802-7600

Other practice location 1

1 Family Practice Dr
Kingston, NY 12401-6449
Phone (845) 338-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20240503001610 GA Practitioner - Family Practice 7719363001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

1910 Hwy 20 SE
Suite 270
Conyers, GA 30013-2082
Phone (678) 413-4380

Hospital & facility affiliations

  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98391GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Jun 24, 2024 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1910 Highway 20 SE
Ste 270
Conyers, GA 30013
Phone (770) 761-0501

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1780247353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 BROADWAY",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014626",
            "telephone_number": "845-802-7600",
            "fax_number": "845-338-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 HIGHWAY 20 SE STE 270",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132082",
            "telephone_number": "770-922-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Family Practice Dr",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124016449",
            "country_code": "US",
            "telephone_number": "845-338-6400",
            "fax_number": "845-399-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROSCHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "319235",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "98391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.