John Clyde Williams IV, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

207952 Issued in LA

Practice address

1664 Mulkey Rd
Austell, GA 30106-1114

Phone

(770) 422-1372

NPI assigned

May 14, 2008

Last updated

May 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA, GA2 enrollments

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 2

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Louisiana State University School of Medicine in Shreveport, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilliams367303@directwellstar.org

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• GBR, LLC

  • Pulmonary Disease Physician
  • Lafayette, LA
  • NPI 1770872616
  Medicare reassignment NPD
• University Hospital & Clinics, Inc.

  • Anesthesiology Physician
  • Lafayette, LA
  • NPI 1639518087
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine EC

  • Family Medicine Physician
  • Marietta, GA
  • NPI 1255633004
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• University Hospital & Clinics Inc

  dba University Hospital & Clinics OutPatient Pharmacy

  • Community/Retail Pharmacy
  • Lafayette, LA
  • NPI 1740739044
  NPD
• Wellstar Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Marietta, GA
  • NPI 1457320319
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  dba Wellstar Douglas Hospital

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1841467198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061114",
            "telephone_number": "770-422-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061114",
            "telephone_number": "770-422-1372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Hospital Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "30076",
            "country_code": "US",
            "telephone_number": "770-410-4366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712017407",
            "country_code": "US",
            "telephone_number": "318-966-4541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-6744",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "81809",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AL",
            "license": "MD.31678",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "81809",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "207952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwilliams367303@directwellstar.org",
            "affiliation": "N",
            "address_1": "4500 Hospital Blvd Ste 310",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wilbert Family Chiropractic, LLC
• Marci Jill Wilbert, DC
• Kizzy Wilkins, APRN
• Eugennie Gloria Williams-Rose
• Jessica Williams, M.D.
• Najla Shahidah Williams
• Porscha Johnson Williams
• Seana-Pierre Williams
• Jade Nicole Willis, PA-C
• Christy Pearl Wilson, PA

• Hospitalist Physician in Austell, GA
• Providers in Austell, GA by specialty
• Hospitalist Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.