Bruce R Williams, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO R9H16 Issued in MO

Practice address

1509 NW Mock Ave
Blue Springs, MO 64015-3096

Phone

(816) 229-8187

Fax

(816) 229-1181

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serafini Medical, P.C.

  • Family Medicine Physician
  • Blue Springs, MO
  • NPI 1184024408
  NPD (past)
• Midwest Heart & Vascular Specialists, LLC

  • Cardiovascular Disease Physician
  • Overland Park, KS
  • NPI 1760736615
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1003801622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 NW MOCK AVE",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153096",
            "telephone_number": "816-229-8187",
            "fax_number": "816-229-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 NW MOCK AVE",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153096",
            "telephone_number": "816-229-8187",
            "fax_number": "816-229-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRUCE",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "DO R9H16",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242574432",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100452270A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin David Wilkerson, M.D.
• Amanda Wilkins, NP
• Wilkinson Family Dentistry, LLC
• Anthony Williams, DDS
• Brandy N Williams, LCSW, MSW
• Kevin Williams
• Tamara Williams, RPH
• Teresa Shontell Williams, MS,RSAP, AAPS
• Rachel Katherine Williston, CPM
• Amanda Mackenzie Wilson, MSN, RN

• Family Medicine Physician in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.