Active NPI
Bruce N Williams, MD
- Family Medicine Physician
- Prineville, OR
National Provider Identifier
1932175106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD14210
- Practice address
- 384 SE Combs Flat Rd
Prineville, OR 97754-2562 - Phone
- (541) 447-6263
- Fax
- (541) 447-8724
- NPI assigned
- Feb 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD14210 | OR | Primary |
Addresses
Primary practice location
384 SE Combs Flat Rd
Prineville, OR 97754-2562
Mailing address
PO Box 7287
Bend, OR 97708-7287
Phone (541) 447-6263
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 269803 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD14210 | OR | MD | Family Medicine Physician |
Interoperability endpoints
- bwilliams17696@secure.stcharleshealthcare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633651200000",
"number": "1932175106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7287",
"city": "BEND",
"state": "OR",
"postal_code": "977087287",
"telephone_number": "541-447-6263",
"fax_number": "541-447-4698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "384 SE COMBS FLAT RD",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977542562",
"telephone_number": "541-447-6263",
"fax_number": "541-447-8724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "BRUCE",
"middle_name": "N",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-27",
"last_updated": "2021-10-08",
"certification_date": "2021-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD14210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "269803",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.