Active NPI
John Williams, OD
- Optometrist
- Williston, ND
National Provider Identifier
1851465108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 373
- Practice address
- 1213 15TH Ave W
Williston, ND 58801-3800 - Phone
- (701) 572-7641
- Fax
- (701) 572-7710
- NPI assigned
- Nov 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 373 | ND | Primary |
Addresses
Primary practice location
1213 15TH Ave W
Williston, ND 58801-3800
Mailing address
1213 15TH Ave W
Williston, ND 58801-3800
Phone (701) 572-7641
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60619 | Medicaid | ND |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 373 | ND | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851465108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 15TH AVE W",
"city": "WILLISTON",
"state": "ND",
"postal_code": "588013800",
"telephone_number": "701-572-7641",
"fax_number": "701-572-7710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 15TH AVE W",
"city": "WILLISTON",
"state": "ND",
"postal_code": "588013800",
"telephone_number": "701-572-7641",
"fax_number": "701-572-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JOHN",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ND",
"license": "373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60619",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston, ND
- William H. Maisey Dentist P.C.
- Williams County Social Services
- Williams County Social Services
- Gayla Phyllis Williams
- Janet Williams, RN
- Love Williams
- Pamela Ernette Williams, PEER SUPPORT
- Williston Basin Eyecare Associates, P.C.
- Williston Center for Pediatric Therapy
- Williston Council for the Aging, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.