Individual provider Active NPI

Kimberly D Williams

  • Occupational Therapist
  • Greensboro, NC
National Provider Identifier
1053071134
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8444 Issued in NC
Practice address
4822 Tower Rd Unit C
Greensboro, NC 27410-5824
Phone
(336) 283-5028
Fax
(336) 291-8784
NPI assigned
Dec 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8444 NC Primary

Addresses

Primary practice location

4822 Tower Rd Unit C
Greensboro, NC 27410-5824

Mailing address

2406 Larkspur Dr
Greensboro, NC 27405-5432
Phone (336) 508-5439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220113000358 NC Practitioner - Occupational Therapist in Private Practice 2062804578 Reassigns benefits to 1 organization
I20240201004100 FL Practitioner - Occupational Therapist in Private Practice 2062804578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regent LLCGroup PAC ID 5698098630, 6 clinicians

Practice addresses (Care Compare)

906 Burch Ave
Durham, NC 27701-2816
Phone (336) 662-3737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8444NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Solana Rehab LLC Occupational Therapist CurrentSince Feb 9, 2025 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Dec 31, 2023 Accepting new patients
Regent LLC Occupational Therapist CurrentSince Feb 15, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Dec 31, 2023 Accepting new patients

Locations

4870 Belfort Rd
Jacksonville, FL 32256
Phone (904) 322-0774

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1053071134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 LARKSPUR DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055432",
            "telephone_number": "336-508-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4822 TOWER RD UNIT C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274105824",
            "telephone_number": "336-283-5028",
            "fax_number": "336-291-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.