Individual provider Active NPI

Todd David Williamson, D.O.

  • Ophthalmology Physician
  • Hattiesburg, MS
National Provider Identifier
1881702447
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16081 Issued in MS
Practice address
100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone
(601) 268-5910
Fax
(601) 264-0659
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 16081 MS Primary

Addresses

Primary practice location

100 Hospital Dr W
Hattiesburg, MS 39402-1334

Mailing address

100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910

Other identifiers 2

IdentifierTypeStateIssuer
00124312MedicaidMS
16081OtherMSMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20100729000502 MS Practitioner - Ophthalmology 2668443573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Eye Clinic, P.a.Group PAC ID 4587733829, 12 clinicians

Practice addresses (Care Compare)

100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as group
Quality
89.54
Improvement activities
40
Cost
53.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery625
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16081MSMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Eye Clinic, P.a. Ophthalmology CurrentSince Sep 20, 2001 Accepting new patients
Hattiesburg Eye Clinic, P.a. CurrentSince Sep 20, 2001 Accepting new patients
Childrens Hospital of Wisconsin, Inc. Past Accepting new patients
Hattiesburg Eye Clinic Cataract & Lasik Surgery Center, LLC PastSince Aug 4, 2004 Accepting new patients

Locations

100 Hospital Dr W
Hattiesburg, MS 39402
Phone (601) 268-5910

Organizations & group practices 4

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881702447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021334",
            "telephone_number": "601-268-5910",
            "fax_number": "601-264-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021334",
            "telephone_number": "601-268-5910",
            "fax_number": "601-264-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "TODD",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "16081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124312",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "16081",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.