Individual provider Active NPI

John Williamson, M.D.

  • Pain Medicine Physician
  • Huntsville, TX
National Provider Identifier
1922069186
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
J2414 Issued in TX
Practice address
133 Medical Park LN Ste B
Huntsville, TX 77340-4979
Phone
(936) 730-8833
Fax
(936) 730-8866
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X J2414 TX Primary

Addresses

Primary practice location

133 Medical Park LN Ste B
Huntsville, TX 77340-4979

Mailing address

4400 FM 1061
Amarillo, TX 79124-4716

Other practice location 1

1020 Riverwood Ct Ste 200
Conroe, TX 77304-2974
Phone (936) 756-3444

Other practice location 2

1901 Medi Park
Suite 2002
Amarillo, TX 79106-2110
Phone (806) 353-4699

Other identifiers 1

IdentifierTypeStateIssuer
141581201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100218000248 TX Practitioner - Pain ManagementPractitioner - Anesthesiology 1254236151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen M Sims MD PAGroup PAC ID 3476655499, 5 clinicians

Practice addresses (Care Compare)

133 Medical Park LN
Suite B
Huntsville, TX 77340-4979
Phone (936) 730-8833

Hospital & facility affiliations

  • Aspire Hospital Hospital, Conroe, TX, CCN 670093
  • Huntsville Memorial Hospital Hospital, Huntsville, TX, CCN 450347
  • CHI St Lukes Health Memorial Livingston Hospital, Livingston, TX, CCN 450395

Merit-based Incentive Payment System (MIPS)

Final score
92.29 of 100Reported as group
Quality
81.37
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2414TXMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conroe Ambulatory Anesthesia PA CurrentSince Apr 5, 2014 Accepting new patients
Stephen M. Sims, MD, PA CurrentSince Sep 1, 2013 Accepting new patients
Stephen M. Sims, MD, PA Pain Medicine CurrentSince Sep 1, 2013 Accepting new patients
Lone Star Anesthesia Consultants PLLC Past Accepting new patients

Locations

4019 I 45 N
#150N
Conroe, TX 77304
Phone (936) 641-8181

4019 I 45 N
#150
Conroe, TX 77304
Phone (936) 641-8181

503 Medical Center Blvd
Ste 110
Conroe, TX 77304
Phone (936) 756-3444

1020 Riverwood Ct
Ste 200
Conroe, TX 77304
Phone (936) 703-5086

133 Medical Park Ln
Ste B
Huntsville, TX 77340
Phone (936) 730-8833

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23958/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1922069186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 FM 1061",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791244716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MEDICAL PARK LN STE B",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404979",
            "telephone_number": "936-730-8833",
            "fax_number": "936-730-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Riverwood Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773042974",
            "country_code": "US",
            "telephone_number": "936-756-3444",
            "fax_number": "936-756-3452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Medi Park",
            "address_2": "Suite 2002",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791062110",
            "country_code": "US",
            "telephone_number": "806-353-4699",
            "fax_number": "806-353-4551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "J2414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141581201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

Verify at the official NPI Registry.