Individual provider Active NPI

Kathy Jo Williams, MD

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1083714240
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44105 Issued in WI
Practice address
5315 Wall St Ste 260
Madison, WI 53718-7937
Phone
(608) 807-1600
Fax
(608) 467-1425
NPI assigned
Sep 25, 2006
Last updated
May 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44105 WI Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 44105 WI

Addresses

Primary practice location

5315 Wall St Ste 260
Madison, WI 53718-7937

Mailing address

PO Box 1239
Troy, MI 48099-1239

Other identifiers 1

IdentifierTypeStateIssuer
34272200MedicaidWI

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520001109 WI Practitioner - Hospice/Palliative CarePractitioner - Family Practice 5395736136 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44105WIMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Family Medicine Current Accepting new patients
Vpa PC Family Medicine CurrentSince Aug 20, 2015 Accepting new patients
Vpa PC Family Medicine CurrentSince Aug 20, 2015 Accepting new patients
Iah of Wisconsin, PLLC Family Medicine CurrentSince May 11, 2015 Accepting new patients

Locations

13555 Bishops Ct
Ste 315
Brookfield, WI 53005
Phone (414) 255-0300

5315 Wall St
Ste 260
Madison, WI 53718
Phone (608) 807-1600

2514 S 102nd St
Ste 160
West Allis, WI 53227
Phone (414) 255-0300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1083714240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 WALL ST STE 260",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537187937",
            "telephone_number": "608-807-1600",
            "fax_number": "608-467-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATHY",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44105",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "WI",
            "license": "44105",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34272200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.