Larry Dean Williamson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8304 Issued in NV

Practice address

330 S Casino Center Blvd
Las Vegas, NV 89101-6102

Phone

(702) 671-5637

Fax

(702) 366-0576

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1972701837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S CASINO CENTER BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016102",
            "telephone_number": "702-671-5637",
            "fax_number": "702-366-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S CASINO CENTER BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016102",
            "telephone_number": "702-671-5637",
            "fax_number": "702-366-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "LARRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21286",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "8304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3910001135",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972701837",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Williamson
• James F Williamson, OD
• Jaquana Simone Williamson
• Jhane Williamson
• Karysa Rose Williamson, RN
• Latisha Williamson
• Lucrecia Williamson
• Mandy Williamson
• Mickelle Williamson
• Shawn Williamson

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.