Individual provider Active NPI

William Scott Livesay, DR MD

  • Obstetrics & Gynecology Physician
  • Waco, TX
National Provider Identifier
1831289719
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D9548 Issued in TX
Practice address
405 Londonderry Dr
Suite 203
Waco, TX 76712-7924
Phone
(254) 772-5855
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D9548 TX Primary

Addresses

Primary practice location

405 Londonderry Dr
Suite 203
Waco, TX 76712-7924

Mailing address

405 Londonderry Dr
Suite 203
Waco, TX 76712-7924
Phone (254) 772-5855

Other identifiers 1

IdentifierTypeStateIssuer
032982301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20090601000385 TX Practitioner - Obstetrics/GynecologyPractitioner - Preventive Medicine 3173672722 Practice locations: Waco, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D9548TXMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1831289719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE 203",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127924",
            "telephone_number": "254-772-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE 203",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127924",
            "telephone_number": "254-772-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVESAY",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DR MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "D9548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032982301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.