DR. SHANE ANTHONY WILLIAMS D.M.D. - NPI 1437315272

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.

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About Dr. Shane Anthony Williams D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANE ANTHONY WILLIAMS D.M.D. (NPI 1437315272) is an individual oral and maxillofacial surgery provider in Bowling Green, Kentucky, licensed in Kentucky (9943) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and maintains a secondary practice location in Nashville.

NPPES Registry Identity

NPI1437315272

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. SHANE ANTHONY WILLIAMSCredential: D.M.D.

Location Address1802 ROCKINGHAM AVEBowling Green, KY 42104-3348

Mailing Address1938 Lyda AvenueBowling Green, KY 42104 · (270) 783-0064 · Fax (270) 901-1997

Phone(270) 783-0064

Fax(270) 901-1997

Sole ProprietorYes

Enumeration DateJuly 31, 2008

Last NPPES UpdateJuly 21, 20226 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2021

✔ NPI 1437315272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Licenses✔ Licensed in KY · 9943✔ Licensed in OK · 332✔ Licensed in TN · 9422

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentist · Oral and Maxillofacial PathologyTaxonomy 1223P0106X · License 9943 (KY)

1802 ROCKINGHAM AVE, Bowling Green, KY 42104

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Secondary Practice Location 1

Location 12400 Patterson Street, Suite 316Nashville, TN 37203-6510 · Phone (615) 327-3534 · Fax (615) 327-3552

Other Identifiers 1

Medicaid1528342TN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Shane Anthony Williams D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 2, 2024 through May 2, 2026.

Opt-Out Effective DateMay 2, 2024

Opt-Out In Effect ThroughMay 2, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TOM P CARTER D.M.D.

Dentist (General Practice)