Individual provider Active NPI

Van Don Williams II, MD

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1053815761
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.151163 Issued in OH
Practice address
3333 Burnet Ave # 9016
Cincinnati, OH 45229-3026
Phone
(513) 636-4200
NPI assigned
Mar 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301507076 MI
Pediatrics Physician 208000000X 308880 NY
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X
Pediatrics Physician 208000000X 35.151163 OH Primary

Addresses

Primary practice location

3333 Burnet Ave # 9016
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave # 9016
Cincinnati, OH 45229-3026

Other practice location 1

1184 5th Ave
New York, NY 10029-6503
Phone (212) 241-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240909003464 OH Practitioner - Pediatric Medicine 5294114724 Reassigns benefits to 1 organization
I20240913003386 MI Practitioner - Pediatric Medicine 5294114724 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
308880NYMDPediatrics Physician
35.151163OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Multi-Specialty CurrentSince Jul 11, 2024 Accepting new patients
Bronson Methodist Hospital Multi-Specialty CurrentSince Jun 28, 2024 Accepting new patients
The Good Samaritan Hospital of Cincinnati, Ohio Past Accepting new patients
Children'S Hospital Medical Center Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
#E352
Kalamazoo, MI 49007
Phone (269) 341-8986

601 John St
Ste E352
Kalamazoo, MI 49007
Phone (269) 341-6475

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

3333 Burnet Ave
#9016
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

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": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1053815761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE # 9016",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE # 9016",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1184 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296503",
            "country_code": "US",
            "telephone_number": "212-241-9500",
            "fax_number": "708-529-2531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VAN DON",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301507076",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "308880",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.151163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.