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DR. JERRY K WILLIAMS JR. M.D.
NPI 1710086749
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Las Vegas, NM

Active since September 22, 2006Opted out of Medicare · through Jul 6, 2028
2301 7TH ST, SUITE B, LAS VEGAS, NM 87701(505) 426-1200(505) 426-1202 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Dr. Jerry K Williams Jr. M.d. NPPES

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

DR. JERRY K WILLIAMS JR. M.D. (NPI 1710086749) is an individual neurology with special qualifications in child neurology provider in Las Vegas, New Mexico, licensed in New Mexico (94-167) and active in the NPI registry since September 2006. He has opted out of Medicare through July 6, 2028.

NPPES Registry Identity

NPI1710086749
Entity TypeIndividualMale
Primary Taxonomy2084N0402X
Provider Legal NameDR. JERRY K WILLIAMS JR.Credential: M.D.
Location Address2301 7TH ST, SUITE BLas Vegas, NM 87701-4966
Mailing AddressPo Box 3861Las Vegas, NM 87701-6861 · (505) 426-1200 · Fax (505) 426-1202
Phone(505) 426-1200
Fax(505) 426-1202
Sole ProprietorYes
Enumeration DateSeptember 22, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1710086749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in NM · 94-167
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
2301 7TH ST, Las Vegas, NM 87701
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Other Identifiers 9

Other201047864NM · Php & Salud
Other00NM009T07NM · Bcbs
Other201311184NM · Tax Id
OtherNM9999NM · Mutual Of Omaha
Medicare UPINF23565NM
Medicare ID-Type Unspecified341429507NM · Nm Medicare
Medicare ID-Type UnspecifiedP00281702NM · Palmetto Gba
OtherC100521093NM · United American
Medicaid23432NM

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

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. Jerry K Williams Jr. 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 July 6, 2018 through July 6, 2028.

Opt-Out Effective DateJuly 6, 2018
Opt-Out In Effect ThroughJuly 6, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

MRS. MARIA L VIGIL LPCC, LMSW
Counselor (Professional)
2301 7TH ST
LAS VEGAS, NM 87701
San Miguel County (505) 454-9611
SAN MIGUEL CLINIC CORP DBA NORTHERN NEW MEXICO UROLOGY
Urology
2301 7TH ST
LAS VEGAS, NM 87701
San Miguel County (505) 454-4000
CHRIS SIXTO MANZANARES LADAC, LBSW
Counselor (Addiction (Substance Use Disorder))
2301 7TH ST
LAS VEGAS, NM 87701
San Miguel County (505) 454-9611
BERNADETTE MONTOYA L.M.H.C.
Counselor (Mental Health)
2301 7TH ST
LAS VEGAS, NM 87701
San Miguel County (505) 454-9611
LINCARE INC
Durable Medical Equipment & Medical Supplies
2301 7TH ST, SUITE B
LAS VEGAS, NM 87701
San Miguel County (727) 431-8462
RIO GRANDE ALCOHOLISM TREATMENT PROGRAM
Community/Behavioral Health
2301 7TH ST
LAS VEGAS, NM 87701
San Miguel County (505) 579-4253

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 Jerry Williams's NPI number?

The NPI number for Jerry Williams is 1710086749. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Where is Jerry Williams located?

Jerry Williams practices at 2301 7th St Suite B, Las Vegas, NM 87701. The listed phone number is (505) 426-1200.

What is Jerry Williams's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Jerry Williams enrolled in Medicare?

No. Jerry Williams has opted out of Medicare through July 6, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jerry Williams was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.