Amy J Williams, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.004600 Issued in OH

Practice address

1252 Ralston Ave Ste 400
Defiance, OH 43512-1480

Phone

(419) 782-6588

Fax

(419) 784-3622

NPI assigned

Nov 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awilliams260533@direct.promedica.org

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Optometrist

  Medicare reassignment Care Compare group NPD
• Mercy Medical Partners Northern Region LLC

  dba Mercy Health Physicians - Defiance Clinic

  • Multi-Specialty Clinic/Center
  • Defiance, OH
  • NPI 1669756532
  Medicare reassignment NPD
• Mercy Medical Partners Northern Region Specialty Care LLC

  • Surgery Physician
  • Defiance, OH
  • NPI 1730701749
  Medicare reassignment NPD
• Mercy Medical Partners Northern Region LLC

  dba Mercy Health - Napoleon Clinic

  • Durable Medical Equipment & Medical Supplies
  • Napoleon, OH
  • NPI 1710405808
  NPD
• Mercy Medical Partners Northern Region Specialty Care LLC

  • Customized Equipment (DME)
  • Defiance, OH
  • NPI 1043972482
  NPD
• Promedica Central Physicians

  dba ProMedica Physicians Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• Don's Optical, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Bryan, OH
  • NPI 1487752291
  NPD (past)
• Fauster Cameron Inc.

  dba Defiance Clinic

  • Multi-Specialty Clinic/Center
  • Defiance, OH
  • NPI 1649253964
  NPD (past)
• Professional Vision Services LLC

  • Optometrist
  • Defiance, OH
  • NPI 1528289659
  NPD (past)
• Tri-State Vision Center, Inc.

  • Optometrist
  • Montpelier, OH
  • NPI 1568573350
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1811979289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 RALSTON AVE STE 400",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435121480",
            "telephone_number": "419-782-6588",
            "fax_number": "419-784-3622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 Meijer Dr # 1",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436173103",
            "country_code": "US",
            "telephone_number": "419-578-2020",
            "fax_number": "419-539-6323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-11-03",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4600T1343",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.004600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2577082",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awilliams260533@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kymberly Whitenburg
• Jacqueline Carol Whitman, RSWA, LCDCII
• Elizabeth M Wilde
• Blakie Lynn Wilhelm, PTA
• Jennifer Wilhelm, LSW
• Christopher Williams, RPH
• Keara Christine Williams
• Sharronda Willis, CNP
• James Wilson, LPC
• Jennifer Michale Wilson

• Optometrist in Defiance, OH
• Providers in Defiance, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.