Individual provider Active NPI

James B Williams II, M.D.

  • Colon & Rectal Surgery Physician
  • Saint Paul, MN
National Provider Identifier
1881617306
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
32791 Issued in MN
Practice address
1983 Sloan PL
11
Saint Paul, MN 55117-2087
Phone
(651) 312-1620
Fax
(651) 312-1570
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 32791 MN Primary

Addresses

Primary practice location

1983 Sloan PL
11
Saint Paul, MN 55117-2087

Mailing address

3433 Broadway St NE Ste 115
Minneapolis, MN 55413-1759
Phone (651) 312-1505

Other identifiers 1

IdentifierTypeStateIssuer
814795700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070620000164 MN Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5991804718 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Colon & Rectal Surgery CurrentSince May 1, 2020 Accepting new patients
Infinite Health Collaborative, PA CurrentSince May 1, 2020 Accepting new patients
Pelvic Floor Center, LLC Colon & Rectal Surgery Past Accepting new patients

Locations

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

1983 Sloan Pl
Ste 11
Saint Paul, MN 55117
Phone (651) 312-1620

1983 Sloan Pl
Ste 7
Saint Paul, MN 55117
Phone (651) 312-1620

Organizations & group practices 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1881617306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 115",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131759",
            "telephone_number": "651-312-1505",
            "fax_number": "651-312-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 SLOAN PL",
            "address_2": "11",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172087",
            "telephone_number": "651-312-1620",
            "fax_number": "651-312-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAMES",
        "middle_name": "B",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MN",
            "license": "32791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "814795700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.