Individual provider Active NPI

Stephen Adebowale Williams, MD

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1780675686
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0070792 Issued in FL
Practice address
714 W Martin Luther King Blvd
Tampa, FL 33603-3104
Phone
(813) 223-6222
Fax
(813) 223-6020
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0070792 FL Primary

Addresses

Primary practice location

714 W Martin Luther King Blvd
Tampa, FL 33603-3104

Mailing address

714 W Martin Luther King Blvd
Tampa, FL 33603-3104
Phone (813) 223-6222

Other identifiers 1

IdentifierTypeStateIssuer
379844500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0070792FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen a Williams, M.D., Inc. Pediatrics CurrentSince Sep 23, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1780675686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W MARTIN LUTHER KING BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033104",
            "telephone_number": "813-223-6222",
            "fax_number": "813-223-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W MARTIN LUTHER KING BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033104",
            "telephone_number": "813-223-6222",
            "fax_number": "813-223-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEPHEN",
        "middle_name": "ADEBOWALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "0070792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379844500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.