Mironda Williams, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

033755 Issued in GA

Practice address

210 Clover Reach
Peachtree City, GA 30269-1657

Phone

(770) 487-9604

Fax

(770) 631-0540

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Medical College of Georgia School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree City Obstetrics and Gynecology, P.C.Group PAC ID 0749277143, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240

  Corporate Director

  CMS ownership

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.

• Peachtree City Obstetrics and Gynecology, P.C.

  • Obstetrics & Gynecology Physician
  • Peachtree City, GA
  • NPI 1447340401
  Medicare reassignment Care Compare group NPD
• Peachtree City Obstetrics and Gynecology, P.C.

  • Obstetrics & Gynecology Physician
  • Newnan, GA
  • NPI 1629410154
  NPD (past)

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

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation
• Piedmont Newnan Hospital, Inc.

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1134133002
  Care Compare affiliation

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780773085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CLOVER REACH",
            "address_2": "P. O. BOX 2505",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691657",
            "telephone_number": "770-487-9604",
            "fax_number": "770-631-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CLOVER REACH",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691657",
            "telephone_number": "770-487-9604",
            "fax_number": "770-631-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MIRONDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "033755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Jackson Williams Jr.
• Jan D. Williams, SLPD
• Keyanna Williams, DMS, PA-C
• Kristina Elaine Williams, OT
• Kyle Edward Williams
• Paige Williams
• Lindsey Willis, DPT
• Mark Willis II, DMD
• Willow Heart Home Care LLC
• Anne Wilson

• Obstetrics & Gynecology Physician in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.