William C Cirillo, M.D.
Individual provider Active NPI Emergency Medicine Physician · Camilla, GA
NPI 1831291228 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831291228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 025531 (GA)
- Practice address
- 90 E. Stevens St
Camilla, GA 31730 - Phone
- (229) 336-4621
- Fax
- (229) 336-4682
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040623000568 | GA | Practitioner - Internal Medicine |
5092790089 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025531 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peach Emergency Group LLC | Emergency Medicine | Current |
Accepting new patients |
| The Hospital Authority of Monroe County, Georgia | Past | Accepting new patients | |
| Bleckley Physician Services LLC | Past | Accepting new patients |
Locations
1960 Highway 247
Byron, GA 31008
Phone (478) 654-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 025531 | GA | Yes |
Addresses
Primary practice location
90 E. Stevens St
Camilla, GA 31730
Mailing address
90 E Stephens St
P. O. Box 639
Camilla, GA 31730-1836
Phone (229) 336-4621
NPI Registry JSON
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831291228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 E STEPHENS ST",
"address_2": "P. O. BOX 639",
"city": "CAMILLA",
"state": "GA",
"postal_code": "317301836",
"telephone_number": "229-336-4621",
"fax_number": "229-336-4682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 E. STEVENS ST",
"city": "CAMILLA",
"state": "GA",
"postal_code": "31730",
"telephone_number": "229-336-4621",
"fax_number": "229-336-4682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIRILLO",
"first_name": "WILLIAM",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "025531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camilla, GA
- Camilla Medical Clinic
- Camilla Pharmacy Inc
- Tabatha Yvonne Carter
- Anthony Blaine Christensen
- Maria Sheila Chupuico
- Lauren F Clemmons
- Mark A Coleman
- Carline Collier
- Collins Professional Services, LLC
- Christine C. Collins
All providers in Camilla, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.