Individual provider Active NPI

Phillip A Williams, O.D.

  • Optometrist
  • Corinth, MS
National Provider Identifier
1912120080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
613 Issued in MS
Practice address
2301 S Harper Rd
Corinth, MS 38834-6771
Phone
(662) 287-1297
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

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
Optometrist 152W00000X 613 MS Primary

Addresses

Primary practice location

2301 S Harper Rd
Corinth, MS 38834-6771

Mailing address

3904 Cedar Creek Dr
Corinth, MS 38834-9693
Phone (662) 287-1061

Other identifiers 1

IdentifierTypeStateIssuer
00880081MedicaidMS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000275 MS Practitioner - Optometry 1658447396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2301 Harper Rd
Corinth, MS 38834-6771

2301 S Harper Rd
Corinth, MS 38834-6771
Phone (662) 287-1297

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
613MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alcorn Eye Care Inc. Optometrist CurrentSince Mar 4, 1997 Accepting new patients

Locations

2301 S Harper Rd
Corinth, MS 38834
Phone (662) 286-1051

Organizations & group practices 1

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912120080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 CEDAR CREEK DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349693",
            "telephone_number": "662-287-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S HARPER RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346771",
            "telephone_number": "662-287-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PHILLIP",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880081",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.