Active NPI
Ivey Williamson, MD
- Internal Medicine Physician
- Signal Mountain, TN
National Provider Identifier
1942274394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 30537
- Practice address
- 37 Old Riding Way
Signal Mountain, TN 37377-2053 - Phone
- (423) 322-8393
- NPI assigned
- Feb 14, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 30537 | TN | Primary |
Addresses
Primary practice location
37 Old Riding Way
Signal Mountain, TN 37377-2053
Mailing address
37 Old Riding Way
Signal Mountain, TN 37377-2053
Phone (423) 322-8393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q023943 | Medicaid | TN |
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 |
|---|---|---|---|
| 30537 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1942274394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 OLD RIDING WAY",
"city": "SIGNAL MOUNTAIN",
"state": "TN",
"postal_code": "373772053",
"telephone_number": "423-322-8393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 OLD RIDING WAY",
"city": "SIGNAL MOUNTAIN",
"state": "TN",
"postal_code": "373772053",
"telephone_number": "423-322-8393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "IVEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "30537",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q023943",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Signal Mountain, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.