DEREK ADAM WILLIAMS (NPI# 1568577633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568577633 |
| Entity Type | Individual |
| Full Name | DEREK ADAM WILLIAMS |
| Credential | DO |
| Practice Address |
Medical Center Blvd Winston Salem NC 27157-0001 |
| Mailing Address |
Po Box 344 Winston Salem NC 27102-0344 |
| Practice Telephone | 3367162255 |
| Mailing Telephone | 3367162255 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
2006-01306 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 143EK | 01 | |
| MEDICARE | 2403409 | 01 | |
| PARTNERS | 808446 | 01 | |
| MEDCOST | 191438 | 01 | |
| WV | 3810007094 | 05 | |
| AETNA | 7318722 | 01 | |
| SC | Q0098E | 05 | |
| NC | 5904911 | 05 | |
| VA | 10401984 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811315435 | Derek Williams | Licensed Practical Nurse | 506 Sw Dexter Cir, Apt 202, Lake City, FL 32025-5675 | 2014-04-01 |
| 1336349448 | Derek Edwin Williams | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2821 E. President George Bush Turnpike, Suite 404, Richardson, TX 75082 | 2007-07-18 |
| 1922107085 | Derek Jrw Williams | Physician Assistant | 320 E 94th St Fl 2, Mount Sinai Adolescent Health Center, New York, NY 10128-5604 | 2006-09-22 |
| 1811907884 | Derek James Williams | Family Medicine | 204 Winslow Road, Clancy, MT 59634 | 2006-08-09 |
| 1760978605 | Derek Williams | Behavioral Analyst | 4001 Office Court Dr Ste 706, Santa Fe, NM 87507-4958 | 2018-07-03 |
| 1942793294 | Derek Williams | Optometrist | 501 Lapeer Ave, Saginaw, MI 48607-1203 | 2018-06-12 |
| 1588016554 | Derek Williams | Dentist | 701 S John Redditt Dr, Lufkin, TX 75904-3122 | 2016-07-01 |
| 1023489234 | Derek Franklin Williams | Counselor | 801 Douglas Ave, Suite 208, Altamonte Springs, FL 32714-5206 | 2015-10-14 |
| 1295135408 | Derek Williams | Counselor | 1695 Main St, Springfield, MA 01103-1348 | 2014-08-26 |
| 1073795134 | Derek Alan Williams | Technician, Other | 599 Tomales Rd, Hs 'a' School, Petaluma, CA 94952-5002 | 2007-11-30 |
| Street Address |
MEDICAL CENTER BLVD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27157-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811990815 | Gary Lee Ray | Registered Nurse | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-05-23 |
| 1881295418 | Alan Townes Grizzard | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-11-02 |
| 1003421751 | Nicholas Ryan Tuttle | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-09-10 |
| 1356956122 | Caitlin Marie Clement | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston Salem, NC 27103 | 2020-09-09 |
| 1376154591 | Lori Sansone Flores | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-08-11 |
| 1821609330 | Hannah Carey Walker | Physician Assistant | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-08-10 |
| 1447876883 | Raveena Mahesh Chhabria | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-06-22 |
| 1780205930 | Jason Chin | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-1087 | 2020-04-29 |
| 1972122885 | Bryanna Dean Vesely | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-04-10 |
| 1679102909 | Ameen Barghi | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-2803 | 2020-04-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960241 | Alexandra Marie Balmaceda | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 | 2020-04-02 |
| 1164916680 | Jorie Elizabeth Gatts | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Department of Pediatrics, Winston Salem, NC 27157 | 2018-06-18 |
| 1932606555 | Alexi Rae Ellington Webb | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine, Dept of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1851896674 | Wasim Muhammad | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-03-25 |
| 1336643535 | Phillip Martin Kostelic | Student in an Organized Health Care Education/Training Program | Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 | 2018-03-21 |
| 1831693324 | Aleah Bond | Student in an Organized Health Care Education/Training Program | Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 | 2018-03-20 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1023467529 | Edward John Doyle IIi | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 | 2016-06-07 |
| 1477917888 | Jordan Mae Burner | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 | 2016-04-12 |
| 1174900476 | Kate Elise Winterbottom | Speech-Language Pathologist | 4 Janeway Medical Center Blvd, Hearing and Speech, Winston Salem, NC 27157 | 2015-05-06 |
| Find all providers in zip 27157 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619599198 | Novant Medical Group, Inc. | Pediatrics | 1350 Whitaker Ridge Dr, Winston Salem, NC 27106-4966 | 2020-05-07 |
| 1225418072 | Novant Medical Group, Inc | Pediatrics | 1900 S. Hawthorne Road, Suite 614, Winston Salem, NC 27103 | 2015-06-08 |
| 1043657398 | Nathaniel Robbins | Pediatrics | Wake Forest University Baptist Medical Ctr, Medical Center Blvd, Winston Salem, NC 27157-0001 | 2013-05-28 |
| 1750487740 | Matthew Alan Hazle | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-09-16 |
| 1154305878 | Wesley Covitz | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912354374 | Carolina Children's Heart Specialists | Pediatrics | 1018 W H Smith Boulevard, Greenville, NC 27834 | 2016-05-16 |
| 1215317060 | Forsyth Memorial Hospital, Inc | Pediatrics | 1941 New Garden Road, Suite 216, Greensboro, NC 27410 | 2015-06-08 |
| 1487903423 | Private Diagnostic Clinic, Pllc | Pediatrics | 540 New Waverly Place, Ste.101, Cary, NC 27518-7422 | 2012-09-06 |
| 1548525470 | Bailliard Henry Pediatric Cardiology | Pediatrics | 4301 Lake Boone Trail, Suite 300, Raleigh, NC 27607 | 2012-07-06 |
| 1275858698 | Carolinas Physicians Network, Inc. | Pediatrics | 705 Griffith Street, Suite 100, Davidson, NC 28036-9305 | 2010-03-29 |
| 1073838496 | Carolinas Physicians Network, Inc. | Pediatrics | 6030 West Highway 74, Suite F, Indian Trail, NC 28079-3469 | 2010-03-29 |
| 1952626376 | Carolinas Physicians Network, Inc. | Pediatrics | 14214 Ballantyne Lake Road, Suite 150, Charlotte, NC 28277-3373 | 2010-03-29 |
| 1902121320 | Carolinas Physicians Network Inc | Pediatrics | 16623 Birkdale Cmns Pkwy Ste 110, Huntersville, NC 28078-5622 | 2010-03-29 |
| 1801023494 | Patsy W Park | Pediatrics | 1545 Orchard Villas Ave Ste 110, Apex, NC 27502-4339 | 2009-06-22 |
| 1114152469 | Frances Chen Travelli | Pediatrics | 1718 E 4th St Ste 605, Charlotte, NC 28204-3282 | 2009-05-15 |
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| City | WINSTON SALEM |
| Zip Code | 27157 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.