Individual provider Active NPI

Kyle Williams

  • Family Medicine Physician
  • Midland, MI
National Provider Identifier
1104230242
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301105865 Issued in MI
Practice address
4009 Orchard Dr
Midland, MI 48640-6122
Phone
(989) 839-3520
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301105865 MI Primary

Addresses

Primary practice location

4009 Orchard Dr
Midland, MI 48640-6122

Mailing address

4009 Orchard Dr
Midland, MI 48640-6122
Phone (989) 839-3520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180629000791 MI Practitioner - Family Practice 0042538399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4611 Campus Ridge Dr
Family Practice Center Midland
Midland, MI 48670-9533
Phone (989) 839-3500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105865MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland Family Medicine CurrentSince Jul 30, 2018 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 30, 2018 Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients

Locations

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4611 N Campus Ridge Dr
Midland, MI 48640
Phone (844) 832-1956

Interoperability endpoints

  • Direct secure messaging: kwilliams7078@mymichiganhealth.midirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1104230242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 ORCHARD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406122",
            "telephone_number": "989-839-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 ORCHARD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406122",
            "telephone_number": "989-839-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301105865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.