DR. BRENT RICHARD WILLIAMS (NPI# 1710125893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710125893 |
| Entity Type | Individual |
| Full Name | DR. BRENT RICHARD WILLIAMS |
| Credential | M.D. |
| Practice Address |
801 Broadway N Fargo ND 58102-3641 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 7012342301 |
| Mailing Telephone | 7012342301 |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2019-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 11253 | ND | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 57.007614 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 10698 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275912073 | Brent Williams | Pharmacist | 2016 Sophia Pl, Lakeland, FL 33811-2684 | 2015-05-26 |
| 1831357664 | Brent Alfred Williams | Family Medicine | 1354 Miller Reed Ave Se, Atlanta, GA 30315-2824 | 2008-05-29 |
| 1447301874 | Brent Thomas Williams | Registered Nurse | 21721 S Cloudview Dr, Oregon City, OR 97045-9160 | 2007-01-14 |
| 1114086444 | Brent A Williams | Dentist | 1719 Section Rd, Cincinnati, OH 45237-3313 | 2006-12-06 |
| 1679958045 | Brent Williams | Pharmacist | 800 Sw 44th St, Oklahoma City, OK 73109-3424 | 2015-07-27 |
| 1295984292 | Brent Max Williams | Dentist | 420 N. Evergreen Rd., Suite 400, Spokane Valley, WA 99216-0993 | 2008-09-15 |
| 1982881140 | Brent Thomas Williams | Pharmacist | 5626 State Highway 7, Oneonta, NY 13820-2050 | 2008-01-29 |
| 1912115197 | Brent Williams | Radiology | 741 President Pl, Smyrna, TN 37167-6807 | 2007-05-19 |
| 1447340831 | Brent C Williams | Internal Medicine | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2006-10-13 |
| 1114963428 | Brent Allan Williams | Internal Medicine | 314 W 14th St, First Floor, New York, NY 10014-5002 | 2006-06-22 |
| Street Address |
801 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-3641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528062924 | Mark F Fisher | Radiology | 801 Broadway N, Fargo, ND 58102-3641 | 2005-06-13 |
| 1942809652 | Morgan Margaret Borud | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2020-10-22 |
| 1790392462 | Katie Thielges | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2020-09-28 |
| 1063022432 | Lindsey Schmidt | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-07-31 |
| 1336766161 | Yesha Shukla | Family Medicine | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-27 |
| 1891310850 | Samantha Mimi Chang | Family Medicine | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-15 |
| 1528683224 | Briana Lee Gebert-oberle | Student in an Organized Health Care Education/Training Program | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-09 |
| 1689296931 | Jillian Virginia Schommer | Student in an Organized Health Care Education/Training Program | 801 Broadway N, Fargo, ND 58102-3641 | 2020-05-09 |
| 1194344036 | Sarah Rose Carpenter | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-04-10 |
| 1346871258 | Randall Hagemeister | Nurse Anesthetist, Certified Registered | 801 Broadway N, Fargo, ND 58102-3641 | 2020-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831519388 | Archana Rajender | Urology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2014-04-23 |
| 1295179687 | Eric Andrew Schommer | Urology | 801 Broadway N, Fargo, ND 58102 | 2013-04-29 |
| 1326301250 | Philip M. Wanzek | Urology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2012-06-15 |
| 1124218664 | Samy Mamdouh Mohamed Heshmat | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2007-07-31 |
| 1629090261 | Theodore J Sawchuk | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-24 |
| 1578585121 | Michael D Segal | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-24 |
| 1720005275 | Thomas A Noah | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-17 |
| 1023049129 | Conrad R Toni | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-07-06 |
| 1639108814 | Steven P Strinden | Urology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2006-07-01 |
| 1447288261 | Kristina L Garrels | Urology | 801 Broadway N, Fargo, ND 58102-3641 | 2006-06-29 |
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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.