Individual provider Active NPI

Steven L. Williams, D.O.

  • Emergency Medicine Physician
  • Gravette, AR
National Provider Identifier
1871535864
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E5615 Issued in AR
Practice address
1101 Jackson St SW
Gravette, AR 72736-9121
Phone
(479) 787-5291
Fax
(479) 344-6410
NPI assigned
Jun 12, 2006
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2000152537 MO
Emergency Medicine Physician 207P00000X E5615 AR Primary

Addresses

Primary practice location

1101 Jackson St SW
Gravette, AR 72736-9121

Mailing address

1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5291

Other identifiers 1

IdentifierTypeStateIssuer
208317701MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 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

Enrollment IDStateProvider typePAC IDDetails
I20080728000568 AR Practitioner - Emergency Medicine 8820054240 Reassigns benefits to 2 organizations
I20140623001630 OK Practitioner - Emergency Medicine 8820054240 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4600OKMDDentist
E5615ARMDEmergency Medicine Physician
2000152537MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cox Barton County Hospital Emergency Medicine CurrentSince Nov 11, 2020 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Feb 1, 2014 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jul 1, 2011 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jul 1, 2011 Accepting new patients
Skaggs Community Hospital Association Emergency Medicine Past Accepting new patients
Mercy Clinic Joplin LLC Past Accepting new patients
Sjmgroup Past Accepting new patients
Integris Grove Hospital Past Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

29 NW 1st Ln
Lamar, MO 64759
Phone (417) 681-5266

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

Organizations & group practices 8

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1871535864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5291",
            "fax_number": "479-344-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5291",
            "fax_number": "479-344-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEVEN",
        "middle_name": "L.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2000152537",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E5615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208317701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravette, AR

Sources for this page

Verify at the official NPI Registry.