Individual provider Active NPI

James D Williams, O.D.

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1962472647
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1810 Issued in NC
Practice address
3732 Creekshire CT
Winston Salem, NC 27103-1363
Phone
(336) 793-5904
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1810 NC Primary

Addresses

Primary practice location

3732 Creekshire CT
Winston Salem, NC 27103-1363

Mailing address

PO Box 607
Pilot Mountain, NC 27041-0607
Phone (336) 368-4727

Other identifiers 5

IdentifierTypeStateIssuer
33982OtherNCMEDCOST
410044135OtherNCRAILROAD MEDICARE
2256632OtherNCUNITED HEALTHCARE
09290OtherNCBCBS
8909290MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100104000309 NC Practitioner - Optometry 3072654706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

118 Golf Course Rd
Pilot Mountain, NC 27041-8410
Phone (336) 368-4727

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1810NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Eye Associates, OD, PLLC Optometrist CurrentSince Oct 25, 2011 Accepting new patients
Tarboro Clinic PA Current Accepting new patients
Professional Vision Care, OD, PLLC Optometrist Current Accepting new patients
Sid PastSince Oct 25, 2011 Accepting new patients

Locations

118 Golf Course Rd
Pilot Mtn, NC 27041
Phone (336) 368-4727

101 Clinic Dr
Tarboro, NC 27886
Phone (252) 823-2105

2807 N Main St
Tarboro, NC 27886
Phone (252) 823-8295

3732 Creekshire Ct
Winston Salem, NC 27103
Phone (336) 793-5900

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1962472647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "PILOT MOUNTAIN",
            "state": "NC",
            "postal_code": "270410607",
            "telephone_number": "336-368-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 CREEKSHIRE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031363",
            "telephone_number": "336-793-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "33982",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410044135",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2256632",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09290",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909290",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.