Individual provider Active NPI

Meredith S Williams, C-PA

  • Medical Physician Assistant
  • Loveland, CO
National Provider Identifier
1194717900
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1890 Issued in CO
Practice address
1708 Boise Ave
Loveland, CO 80538-4204
Phone
(970) 667-3116
Fax
(970) 669-0159
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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 1890 CO Primary

Addresses

Primary practice location

1708 Boise Ave
Loveland, CO 80538-4204

Mailing address

1708 Boise Ave
Loveland, CO 80538-4204
Phone (970) 667-3116

Other practice location 1

905 Alpine Ave
Boulder, CO 80304-3305
Phone (970) 667-3116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20040423000397 CO Practitioner - Physician Assistant 6305831512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Loveland Dermatology PCGroup PAC ID 1456329655, 5 clinicians

Practice addresses (Care Compare)

1708 Boise Ave
Loveland, CO 80538-4204
Phone (970) 667-3116

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0047672FLMDDermatology Physician
1890COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ingerlisa Mattoch MD Inc Current Accepting new patients
Lake Loveland Dermatology PC CurrentSince Oct 1, 2017 Accepting new patients
Skin PC Past Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Stephen a Spencer MD PA Past Accepting new patients

Locations

1101 Oakridge Dr
Fort Collins, CO 80525
Phone (970) 207-9773

1708 Boise Ave
Loveland, CO 80538
Phone (970) 663-0815

1405 S 8th Ave
Ste 102
Sterling, CO 80751
Phone (970) 522-0591

1683 Main St
Windsor, CO 80550
Phone (970) 400-7618

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1194717900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805384204",
            "telephone_number": "970-667-3116",
            "fax_number": "970-669-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805384204",
            "telephone_number": "970-667-3116",
            "fax_number": "970-669-0159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 Alpine Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043305",
            "country_code": "US",
            "telephone_number": "970-667-3116",
            "fax_number": "970-669-0159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MEREDITH",
        "middle_name": "S",
        "credential": "C-PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.