Johnny Lee Williams, M.D.
Individual provider Active NPI Addiction Medicine (Psychiatry & Neurology) Physician · Greenville, NC
NPI 1972697746 · NPPES record last updated Dec 10, 2024
Key facts
- NPI
- 1972697746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
- License
- 20584 (NC)
- Practice address
- 203 Government Cir
Greenville, NC 27834-8198 - Phone
- (252) 413-1637
- Fax
- (252) 317-0316
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091007000267 | NC | Practitioner - Addiction Medicine |
1951447861 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20584 | NC | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc. | Current |
Accepting new patients | |
| Easter Seals Ucp North Carolina & Virginia, Inc. | Current |
Accepting new patients | |
| Easter Seals Ucp North Carolina & Virginia, Inc. | Current | Accepting new patients | |
| Apex Therapeutic Services, PLLC | Past | Accepting new patients | |
| Apex Behavioral Healthcare | Past | Accepting new patients |
Locations
4300 Sapphire Ct
Ste 110
Greenville, NC 27834
Phone (252) 830-7540
2602 Courtier Dr
Greenville, NC 27834
Phone (252) 355-4725
203 Government Cir
Greenville, NC 27834
Phone (252) 413-1600
215 Memorial Dr
Bldg B
Jacksonville, NC 28546
Phone (910) 378-2498
231 Memorial Dr
Ste Ab
Jacksonville, NC 28546
Phone (910) 353-5354
2901 N Herritage St
Ste B
Kinston, NC 28501
Phone (252) 233-2383
5171 Glenwood Ave
Ste 211
Raleigh, NC 27612
Phone (919) 210-7661
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 20584 | NC | Yes |
| Obstetrics & Gynecology Physician | 207V00000X | 20584 | NC |
Addresses
Primary practice location
203 Government Cir
Greenville, NC 27834-8198
Mailing address
203 Government Cir
Greenville, NC 27834-8198
Phone (252) 413-1637
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34D0944653 | Other | NC | CLIA |
| 87700 | Other | NC | BCBSNC |
| 8987700 | Medicaid | NC | |
| 0728888 | Other | NC | UNITED HEALTHCARE |
| 20584 | Other | NC | MEDICAL LICENSE |
Other providers in Greenville, NC
- Jasmine Alexis Williams
- Jennifer Stancil Williams
- Jill S Williams
- Jillian Holloman Williams
- John Mark Williams
- Joshua Nemiah Williams
- Latasha April Williams
- Laurin Williams
- Marilyn Williams
- Nathan Ryan Williams
All providers in Greenville, NC · Addiction Medicine (Psychiatry & Neurology) Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.