Individual provider Active NPI

Jason Bryan Williams, D.C

  • Chiropractor
  • Christiansted, VI
National Provider Identifier
1841548088
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
62 Issued in VI
Practice address
RR1 Box 10556
The Village Mall Bay12
Christiansted, VI 00850-9604
Phone
(340) 773-4300
Fax
(340) 773-4301
NPI assigned
Aug 20, 2012
Last updated
Aug 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 62 VI Primary

Addresses

Primary practice location

RR1 Box 10556
The Village Mall Bay12
Christiansted, VI 00850-9604

Mailing address

RR1 Box 10556
The Village Mall Bay12
Christiansted, VI 00850-9604
Phone (340) 773-4300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190429002376 VI Practitioner - Chiropractic 2860734548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

The Village Mall Bay
12 RR1 Box 10556
Kingshill, VI 00850-9604
Phone (340) 773-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62VIMDChiropractor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1841548088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR1 BOX 10556",
            "address_2": "THE VILLAGE MALL BAY12",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008509604",
            "telephone_number": "340-773-4300",
            "fax_number": "340-773-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR1 BOX 10556",
            "address_2": "THE VILLAGE MALL BAY12",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008509604",
            "telephone_number": "340-773-4300",
            "fax_number": "340-773-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JASON",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-20",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VI",
            "license": "62",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansted, VI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.