Jennifer Williams, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G55656 Issued in CA

Practice address

652 Petaluma Ave
Suite F
Sebastopol, CA 95472-4266

Phone

(707) 823-2334

Fax

(707) 823-3007

NPI assigned

Apr 5, 2006

Last updated

Jan 6, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jwilliams60359@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1821050766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 PETALUMA AVE",
            "address_2": "SUITE F",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724266",
            "telephone_number": "707-823-2334",
            "fax_number": "707-823-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 PETALUMA AVE",
            "address_2": "SUITE F",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724266",
            "telephone_number": "707-823-2334",
            "fax_number": "707-823-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821050766",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin West, MSW, LCSW
• Juliet Wettle, RDN
• Kathleen Ellen Whisman, M.D.
• Andrew Williams, A.T.C.
• James Williams, CHT
• Shannon Williams
• Andrea Williamson, MFT
• David Wise, PH.D.
• Jurgen Woelke, L.AC.
• Laura Woodlander, CMT

• Family Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.