Keegan Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34012365A Issued in IN

Practice address

436 E Washington Blvd
Fort Wayne, IN 46802-3210

Phone

(260) 200-5347

NPI assigned

Mar 7, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alliance Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1316556848
  Medicare reassignment NPD
• Alliance Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, IN
  • NPI 1013880913
  NPD

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1124728191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12711 SLASH PASS",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468180063",
            "telephone_number": "260-414-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 E WASHINGTON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023210",
            "telephone_number": "260-200-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEEGAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34012365A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S. Williams, PA-C
• Jennifer Michele Williams, DC
• John I Williams, MD
• Juan Deon Williams
• Judith L Williams, PSY.D.
• Kishyla Williams
• Kyra Williams
• Logan Alan Williams, CRNA
• Mackenzie Linn Williams, ATC, LAT
• Megan Lucille Williams, MA

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.