NPIMap

Individual provider Active NPI

Marvin H. Williams Jr., M.D.

  • Emergency Medicine Physician
  • Springfield, OH
National Provider Identifier
1841300159
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9700809 Issued in NC
Practice address
1176 E Home Rd
Suite O
Springfield, OH 45503-2726
Phone
(937) 398-0051
Fax
(937) 398-0054
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-051235 OH
Emergency Medicine Physician 207P00000X 35.051235 OH
Emergency Medicine Physician 207P00000X 9700809 NC Primary
Family Medicine Physician 207Q00000X 9700809 NC

Addresses

Primary practice location

1176 E Home Rd
Suite O
Springfield, OH 45503-2726

Mailing address

1176 E Home Rd
Suite O
Springfield, OH 45503-2726
Phone (937) 398-0051

Other identifiers 3

IdentifierTypeStateIssuer
000000335653OtherOHANTHEM
000000544524OtherOHANTHEM
2477181MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9700809NCMDEmergency Medicine Physician
35.051235OHMDEmergency Medicine Physician
35-051235OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Community Urgent Care Inc. PastSince Feb 1, 2000 Accepting new patients
South Charleston Medical Center Family Medicine Past Accepting new patients
Community Urgent Care Inc. Past Accepting new patients
Springfield Emergency Physicians, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1841300159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 E HOME RD",
            "address_2": "SUITE O",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032726",
            "telephone_number": "937-398-0051",
            "fax_number": "937-398-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 E HOME RD",
            "address_2": "SUITE O",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032726",
            "telephone_number": "937-398-0051",
            "fax_number": "937-398-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARVIN",
        "middle_name": "H.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-051235",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.051235",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9700809",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9700809",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000335653",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000544524",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2477181",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.