Active NPI
Evon Anthony Williamson, M.D.
- Anesthesiology Physician
- Washington, DC
National Provider Identifier
1942308812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD035511
- Practice address
- 1310 Southern Ave SE
Washington, DC 20032-4623 - Phone
- (202) 574-6851
- Fax
- (202) 279-7370
- NPI assigned
- Sep 21, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD035511 | DC | Primary |
Addresses
Primary practice location
1310 Southern Ave SE
Washington, DC 20032-4623
Mailing address
PO Box 784305
Philadelphia, PA 19178-4305
Phone (844) 565-6473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 039120800 | Medicaid | DC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privium Consultants LLC | Current | Accepting new patients | |
| Providence Health Services, Inc | Anesthesiology | Past | Accepting new patients |
Locations
8222 Schultz Rd
Clinton, MD 20735
Phone (202) 600-5683
7801 Old Branch Ave
Ste 202
Clinton, MD 20735
Phone (202) 221-8442
9135 Piscataway Rd
Ste 410
Clinton, MD 20735
Phone (240) 348-7860
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Washington, DC
- NPI 1740795293
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": "1446508800000",
"number": "1942308812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 784305",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191784305",
"telephone_number": "844-565-6473",
"fax_number": "302-733-0854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 SOUTHERN AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200324623",
"telephone_number": "202-574-6851",
"fax_number": "202-279-7370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "EVON",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "DC",
"license": "MD035511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "039120800",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.