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JONATHAN KOULOUBIS WILLIAMSON
NPI 1457930075
Pediatrics - Pediatric Emergency Medicine in Little Rock, AR

Active since April 02, 2021PECOS Enrolled
1 CHILDRENS WAY # 512-19A, LITTLE ROCK, AR 72202(501) 364-1874 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jonathan Kouloubis Williamson NPPES

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

JONATHAN KOULOUBIS WILLIAMSON (NPI 1457930075) is an individual pediatric emergency medicine provider in Little Rock, Arkansas, licensed in Arkansas (E-17782) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of University Of Arkansas College Of Medicine (2021).

NPPES Registry Identity

NPI1457930075
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameJONATHAN KOULOUBIS WILLIAMSON
Location Address1 CHILDRENS WAY # 512-19ALittle Rock, AR 72202-3500
Mailing Address24 Fontenay CirLittle Rock, AR 72223-9568
Phone(501) 364-1874
Sole ProprietorYes
Medical School CMSUniversity Of Arkansas College Of MedicineGraduated 2021
Enumeration DateApril 2, 2021
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
✔ NPI 1457930075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in AR · E-17782
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License E-17782 (AR)
1 CHILDRENS WAY # 512-19A, Little Rock, AR 72202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Kouloubis Williamson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820499254
PECOS Enrollment IDI20251027000907
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jonathan Williamson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Arkansas Childrens Professional Services Organization LLC
3.4 mi
Pediatrics
1 CHILDRENS WAY
Little Rock, AR 72202
  • Reassigned Medicare billing, Arkansas enrollment
  • 653 clinicians in this Medicare group
NPI 1629889464 (501) 364-2526

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

MR. JONATHAN L ASKINS JR. MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5155
HEMA JOSHI
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
MYIA DICKERSON DO
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5115
JENNIFER BRITO WARNER MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (479) 364-5115
DR. LESLIE HELENE ST. PIERRE MD
Pediatrics
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5115
MAKENZIE LAINE NIVEN MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
DR. HAMSINI MOVVA MBBS
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
DR. TIMOTHY EDWARD NISSEN DO
Pediatrics (Pediatric Cardiology)
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Williamson's NPI number?

The NPI number for Jonathan Williamson is 1457930075. It was assigned to this individual provider in the NPPES registry on April 2, 2021.

Where is Jonathan Williamson located?

Jonathan Williamson practices at 1 Childrens Way # 512-19a, Little Rock, AR 72202. The listed phone number is (501) 364-1874.

What is Jonathan Williamson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Jonathan Williamson enrolled in Medicare?

Yes. Jonathan Williamson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jonathan Williamson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Williamson reassigns Medicare benefits to Arkansas Childrens Professional Services Organization LLC (Little Rock, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jonathan Williamson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jonathan Williamson accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Jonathan Williamson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jonathan Williamson was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.