Active NPI
Robert D Williams, MD
- Family Medicine Physician
- Draper, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1855221205
- Practice address
- 11724 S State St
Draper, UT 84020-7163 - Phone
- (801) 965-3600
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1855221205 | UT | Primary |
Addresses
Primary practice location
11724 S State St
Draper, UT 84020-7163
Mailing address
2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11348 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1855221205 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Medical Specialists LLC | Current | Accepting new patients | |
| Granger Medical Specialists, LLC | Current | Accepting new patients | |
| Granger Medical Clinic PC | Current | Accepting new patients | |
| Granger Medical Clinic PC | Family Medicine | Current | Accepting new patients |
Locations
11724 S State St
Draper, UT 84020
Phone (801) 576-2000
12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700
1288 W 12700 S
Riverton, UT 84065
Phone (801) 253-3500
995 W Levoy Dr
Taylorsville, UT 84123
7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505
3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545
2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505
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.
-
- Multi-Specialty Clinic/Center
- West Valley City, UT
- NPI 1184657041
Family Medicine
-
- Clinic/Center
- West Valley City, UT
- NPI 1376159368
-
- Multi-Specialty Clinic/Center
- West Jordan, UT
- NPI 1104857549
-
- Multi-Specialty Clinic/Center
- Salt Lake City, UT
- NPI 1497441539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1063596401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2965 W 3500 S",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841193602",
"telephone_number": "801-965-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11724 S STATE ST",
"city": "DRAPER",
"state": "UT",
"postal_code": "840207163",
"telephone_number": "801-965-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ROBERT",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "1855221205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11348",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.