Individual provider Active NPI

Kimberly J Williams, PA-C

  • Medical Physician Assistant
  • Mifflintown, PA
National Provider Identifier
1184650194
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA-000783-L Issued in PA
Practice address
HC 63 Box 48C
Mifflintown, PA 17059-9049
Phone
(717) 436-5578
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA-000783-L PA Primary

Addresses

Primary practice location

HC 63 Box 48C
Mifflintown, PA 17059-9049

Mailing address

PO Box 67
Mifflintown, PA 17059-0067
Phone (717) 436-5578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519000427 PA Practitioner - Physician Assistant 2860483914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

21 Geisinger LN
Lewistown, PA 17044-3400
Phone (717) 242-4200

27 Sandy LN
Lewistown, PA 17044-1310
Phone (717) 242-2711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA-000783-LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Apr 1, 2014 Accepting new patients
Family Health Associates of Lewistown CurrentSince Oct 1, 2006 Accepting new patients
Geisinger Clinic CurrentSince Apr 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients
Recalde Ear Nose & Throat Clinic PC Past Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

27 Sandy Ln
Lewistown, PA 17044
Phone (717) 242-0311

27 Sandy Ln
Ste 250
Lewistown, PA 17044
Phone (717) 242-7332

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

Interoperability endpoints

  • Direct secure messaging: kwilliams115796@direct.geisinger.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184650194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "MIFFLINTOWN",
            "state": "PA",
            "postal_code": "170590067",
            "telephone_number": "717-436-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 63 BOX 48C",
            "city": "MIFFLINTOWN",
            "state": "PA",
            "postal_code": "170599049",
            "telephone_number": "717-436-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA-000783-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mifflintown, PA

Sources for this page

Verify at the official NPI Registry.