Individual provider Active NPI

Mavis Williams Billips, M.D.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1902905664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A051005 Issued in CA
Practice address
8631 W 3Rd St
Suite 1135 E
Los Angeles, CA 90048-5901
Phone
(310) 651-8240
Fax
(310) 651-8254
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A051005 CA Primary

Addresses

Primary practice location

8631 W 3Rd St
Suite 1135 E
Los Angeles, CA 90048-5901

Mailing address

4712 Admiralty Way
Suite 665
Marina del Rey, CA 90292-6905
Phone (310) 678-2686

Other names 1

  • Dr. Mavis Theodora Williams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050819000399 CA Practitioner - Dermatology 4284664129

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Warren Alpert Medical School of Brown University, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4712 Admiralty Way
Suite 665
Marina del Rey, CA 90292-6905

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51005CAMDGeneral Practice Dentistry
A051005CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902905664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY",
            "address_2": "SUITE 665",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-678-2686",
            "fax_number": "310-651-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 1135 E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-651-8240",
            "fax_number": "310-651-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLIPS",
        "first_name": "MAVIS",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A051005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAVIS",
            "last_name": "WILLIAMS",
            "middle_name": "THEODORA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.