Individual provider Active NPI

Keith D Williams, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Germantown, TN
National Provider Identifier
1154318947
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
21571 Issued in TN
Practice address
1400 S Germantown Rd
Germantown, TN 38138-2205
Phone
(901) 759-3100
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 21571 TN Primary

Addresses

Primary practice location

1400 S Germantown Rd
Germantown, TN 38138-2205

Mailing address

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

Other practice location 1

7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3100

Other practice location 2

1211 Union Ave Ste 500
Memphis, TN 38104-6656
Phone (901) 759-3100

Other practice location 3

1458 W Poplar Ave Ste 100
Collierville, TN 38017-0630
Phone (901) 759-3100

Other practice location 4

8000 Centerview Pkwy Ste 500
Cordova, TN 38018-4254
Phone (901) 759-3100

Other identifiers 4

IdentifierTypeStateIssuer
00124453MedicaidMS
004420759MedicaidMS
Q016958MedicaidTN
120338001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101027000827 MS Practitioner - Orthopedic Surgery 4981898665 Reassigns benefits to 1 organization
I20101029000257 TN Practitioner - Orthopedic Surgery 4981898665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3196

7887 Wolf River Blvd
Germantown, TN 38138-1718
Phone (901) 759-3100

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion171
Laminectomy or laminotomy (partial removal of spine bones)62
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21571TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC Orthopaedic Surgery of the Spine CurrentSince Jul 26, 1991 Accepting new patients
Campbell Clinic PC CurrentSince Jul 26, 1991 Accepting new patients
Campbell Clinic Past Accepting new patients
CC Bpci PLC Past Accepting new patients

Locations

7545 Airways Blvd
Southaven, MS 38671
Phone (901) 759-3196

1458 W Poplar Ave
Ste 100
Collierville, TN 38017
Phone (901) 759-5491

7887 Wolf River Blvd
Memphis, TN 38138
Phone (901) 759-3180

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

1211 Union Ave
Ste 500
Memphis, TN 38104
Phone (901) 759-3275

Interoperability endpoints

  • Direct secure messaging: keith.williams.1@1366.direct.athenahealth.com
  • Direct secure messaging: kwilliams@cco1043.srs-direct.com
  • Direct secure messaging: kwilliams29069@mlh.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 5

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1154318947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7545 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715806",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Union Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381046656",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1458 W Poplar Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380170630",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8000 Centerview Pkwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380184254",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEITH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TN",
            "license": "21571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124453",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004420759",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016958",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120338001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.