Individual provider Active NPI

David M Williams, PSY.D.

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1063591394
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2282-057 Issued in WI
Practice address
9720 W Bluemound Rd
Milwaukee, WI 53226-4454
Phone
(414) 774-1794
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2282-057 WI Primary

Addresses

Primary practice location

9720 W Bluemound Rd
Milwaukee, WI 53226-4454

Mailing address

W276N2792 Trillium LN
Pewaukee, WI 53072-4378

Other identifiers 1

IdentifierTypeStateIssuer
39696500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070501000674 WI Practitioner - Clinical Psychologist 2062518475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Behavioral Clinics SCGroup PAC ID 7517937964, 46 clinicians

Practice addresses (Care Compare)

10424 W Bluemound Rd
Milwaukee, WI 53226-4331
Phone (414) 774-1794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2282-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Behavioral Clinics, SC CurrentSince Jul 15, 2002 Accepting new patients

Locations

9720 W Bluemound Rd
Milwaukee, WI 53226
Phone (414) 378-7553

7330 W Layton Ave
Milwaukee, WI 53220
Phone (414) 281-1677

10424 W Bluemound Rd
Wauwatosa, WI 53226
Phone (414) 206-1606

Organizations & group practices 1

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063591394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W276N2792 TRILLIUM LN",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 W BLUEMOUND RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264454",
            "telephone_number": "414-774-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2282-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39696500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.