Active NPI
Nicholas Andrew Williams, PA-C
- Medical Physician Assistant
- Salem, OR
National Provider Identifier
1982014049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA174620
- Practice address
- 4999 Skyline Rd S
Salem, OR 97306-2878 - Phone
- (503) 364-4005
- Fax
- (503) 364-4006
- NPI assigned
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA174620 | OR | Primary |
Addresses
Primary practice location
4999 Skyline Rd S
Salem, OR 97306-2878
Mailing address
PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
354 W Adams Ave
Sisters, OR 97759-2619
Phone (541) 549-9609
4999 Skyline Rd S
Suite 100
Salem, OR 97306-0001
Phone (503) 364-4005
Hospital & facility affiliations
- Salem Health West Valley
- Salem Hospital
- Santiam Hospital & Clinics
- Willamette Valley Medical Center
- Samaritan Albany General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA174620 | OR | MD | Medical Physician Assistant |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Bend, OR
- NPI 1821068164
Hospital & facility affiliations 22
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albany, OR
- NPI 1154372340
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Albany, OR
- NPI 1326755158
Hospital
-
- Endocrinology, Diabetes & Metabolism Physician
- Albany, OR
- NPI 1346620408
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682035200000",
"number": "1982014049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1517",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978010410",
"telephone_number": "877-708-1119",
"fax_number": "541-278-8349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4999 SKYLINE RD S",
"city": "SALEM",
"state": "OR",
"postal_code": "973062878",
"telephone_number": "503-364-4005",
"fax_number": "503-364-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "NICHOLAS",
"middle_name": "ANDREW",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-29",
"last_updated": "2023-04-21",
"certification_date": "2023-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OR",
"license": "PA174620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.