Patrick Shane Williams, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

191369 Issued in NC

Practice address

123 Professional Park Drive
Locust, NC 28097-7712

Phone

(704) 631-0002

NPI assigned

Jun 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Brody School of Medicine at East Carolina University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Unc Physicians Network Group Practices LLCGroup PAC ID 7810142833, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Durham, NC, CCN 347110
• Rex Hospital Hospital, Raleigh, NC, CCN 340114

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Unc Physicians Network Group Practices, LLC

  dba Boylan Healthcare

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1275872905
  Medicare reassignment Care Compare group NPD
• Unc Physicians Network Group Practices, LLC

  dba Carolina Foot and Ankle Specialists

  • Foot & Ankle Surgery Podiatrist
  • Raleigh, NC
  • NPI 1053973354
  NPD
• Unc Physicians Network Group Practices, LLC

  dba Garner Family Practice

  • Family Medicine Physician
  • Garner, NC
  • NPI 1992192694
  NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Primary Care Cabarrus Family Medicine

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1144336587
  NPD (past)
• Garner Family Practice PA

  • Family Medicine Physician
  • Garner, NC
  • NPI 1700841103
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys North Carolina, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Durham, NC
  • NPI 1083669873
  Care Compare affiliation
• Rex Hospital Inc.

  dba Rex Hospital

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629504000000",
    "number": "1891133344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PROFESSIONAL PARK DRIVE",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280977712",
            "telephone_number": "704-631-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Poole Dr",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275295207",
            "country_code": "US",
            "telephone_number": "919-779-1440",
            "fax_number": "919-662-0613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICK",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2021-08-21",
        "certification_date": "2021-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "191369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891133344",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwilliams307951@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "801 Poole Dr",
            "city": "Garner",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275295207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aimee Leigh Walther, PHARMD
• Amanda Watson, PHARMD
• Joanna Michelle Weeks
• West Stanly Imaging LLC (Atrium Health Imaging Locust)
• West Stanly Imaging LLC (Atrium Health Imaging Locust)
• Kristina Marie Wilson, FNP
• Alyssa Lauren Winkler
• Kadi-Ann Verna Wong, MSW
• Daniel Joesph Wright, DC
• Harrison Wright, D.C.

• Family Medicine Physician in Locust, NC
• Providers in Locust, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.