Jesse Carl Williams, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1909DT Issued in KY

Practice address

1806 N. 4TH St
Murray, KY 42071

Phone

(270) 759-1429

Fax

(270) 759-1493

NPI assigned

Jul 17, 2012

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in KY

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

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Kentucky Professional, PLLCGroup PAC ID 6204375165, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.84 of 100Reported as individual

Quality

77.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jesse.williams@direct.revolutionehr.com

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.

• Aeg Kentucky Professional, PLLC

  • Optometrist
  • Alton, IL
  • NPI 1467214080

  KY

  Medicare reassignment Care Compare group NPD
• Jarvis Vision Center, PLLC

  • Optometrist
  • Murray, KY
  • NPI 1568657526
  Medicare reassignment
• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD (past)

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1821343708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 N. 4TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "42071",
            "telephone_number": "270-759-1429",
            "fax_number": "270-759-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 N. 4TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "42071",
            "telephone_number": "270-759-1429",
            "fax_number": "270-759-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSE",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1909DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100327030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle N Wiggins, APRN
• Deborah L Wiles, NP
• Lindsey Paige Wilferd, PA-C
• Allyson Kay Williams, APRN
• Charlsie Rhea Williams, PHARM.D
• Robert T Williams, M.D.
• Chloe Williamson
• Angela Willis
• Amber Dawn Wilson, MSPT, DPT
• William Ryker Wilson

• Optometrist in Murray, KY
• Providers in Murray, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.