Individual provider Active NPI

Justin K Williams, NP-C

  • Gerontology Nurse Practitioner
  • Macon, GA
National Provider Identifier
1962390591
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN254892 Issued in GA
Practice address
5400 Bowman Rd Ste 100
Macon, GA 31210-8879
Phone
(478) 745-6576
Fax
(478) 746-0018
NPI assigned
Jun 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN254892 GA Primary

Addresses

Primary practice location

5400 Bowman Rd Ste 100
Macon, GA 31210-8879

Mailing address

5400 Bowman Rd Ste 100
Macon, GA 31210-8879
Phone (478) 745-6576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813003968 GA Practitioner - Nurse Practitioner 6103324561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists of GeorgiaGroup PAC ID 1153312574, 9 clinicians

Practice addresses (Care Compare)

5400 Bowman Rd
Suite 100
Macon, GA 31210-8879
Phone 47874565761204

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialists of Georgia CurrentSince Jun 26, 2025 Accepting new patients
Gastroenterology Associates of Central Ga, LLC PastSince Jun 26, 2025 Accepting new patients

Locations

5400 Bowman Rd
Ste 100
Macon, GA 31210
Phone (478) 745-6576

Interoperability endpoints

  • Direct secure messaging: jwilliams434636@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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 1

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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1962390591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 BOWMAN RD STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108879",
            "telephone_number": "478-745-6576",
            "fax_number": "478-746-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BOWMAN RD STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108879",
            "telephone_number": "478-745-6576",
            "fax_number": "478-746-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUSTIN",
        "middle_name": "K",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN254892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.