Organization Active NPI

Kelcey L. Williams, MD, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Dothan, AL
National Provider Identifier
1073823522
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
L7926 Issued in TX
Legal business name
KELCEY L. WILLIAMS, MD, PLLC
Practice address
1736 E Main St
Dothan, AL 36301-3040
Phone
(334) 712-6333
Fax
(334) 793-6428
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Dr. Kelcey L. Williams, M.D.
Title
Owner/Rendering Provider
Phone
(512) 363-5779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X L7926 TX Primary

Addresses

Primary practice location

1736 E Main St
Dothan, AL 36301-3040

Mailing address

104 Apple Ave
Ste 3 #114
Dothan, AL 36303-1291
Phone (817) 284-9850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110308000401 TX Part B Supplier - Clinic/Group Practice 3870775158 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pearland, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

104 Apple Ave
Ste 3
Dothan, AL 36303

2541 S Ih 35
#200242
Round Rock, TX 78664

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1073823522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 APPLE AVE",
            "address_2": "STE 3 #114",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031291",
            "telephone_number": "817-284-9850",
            "fax_number": "949-222-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 E MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013040",
            "telephone_number": "334-712-6333",
            "fax_number": "334-793-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELCEY L. WILLIAMS, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KELCEY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/RENDERING PROVIDER",
        "authorized_official_telephone_number": "512-363-5779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "L7926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.