Individual provider Active NPI

Patrick G. Williams, MD

  • Pediatrics Physician
  • Miles City, MT
National Provider Identifier
1962585844
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
37662 Issued in IA
Practice address
620 S Haynes Ave
Miles City, MT 59301-4769
Phone
(406) 233-7000
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 37662 IA Primary

Addresses

Primary practice location

620 S Haynes Ave
Miles City, MT 59301-4769

Mailing address

1223 So Gear Ave
Suite 108
West Burlington, IA 52655-1685
Phone (319) 753-5177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830003698 IA Practitioner - Pediatric Medicine 0345247581 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37662IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients

Locations

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

1223 S Gear Ave
Ste 108
West Burlington, IA 52655
Phone (319) 753-5177

Interoperability endpoints

  • Direct secure messaging: pwilliams639132@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1962585844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 SO GEAR AVE",
            "address_2": "SUITE 108",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551685",
            "telephone_number": "319-753-5177",
            "fax_number": "319-753-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S HAYNES AVE",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593014769",
            "telephone_number": "406-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICK",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "37662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miles City, MT

Sources for this page

Verify at the official NPI Registry.