NPIMap

Individual provider Active NPI

Jon Williams, DO

  • Emergency Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1205339058
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101026921 Issued in MI
Practice address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone
(269) 337-6039
NPI assigned
Mar 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151014599 MI
Emergency Medicine Physician 207P00000X 5101026921 MI Primary

Addresses

Primary practice location

1000 Oakland Dr
Kalamazoo, MI 49008-1282

Mailing address

3226 Pine Bluff LN
Kalamazoo, MI 49008-2523
Phone (208) 521-2072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630000008 ID Practitioner - Emergency Medicine 9638591332 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caribou Medical Center, IncGroup PAC ID 7618365701, 35 clinicians

Practice addresses (Care Compare)

300 S 3Rd
Soda Springs, ID 83276-1559
Phone 20854733417503

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111

Hospital & facility affiliations

  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
  • Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074
  • Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025
  • Caribou Medical Center Hospital, Soda Springs, ID, CCN 131309

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mountain View Hospital LLC CurrentSince Nov 1, 2024 Accepting new patients
North Canyon Medical Center Inc. Current Accepting new patients
Caribou Medical Center, Inc CurrentSince Nov 5, 2025 Accepting new patients
Caribou Medical Center, Inc CurrentSince Nov 5, 2025 Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Western University of Health Sciences Past Accepting new patients

Locations

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

300 S 3rd W
Soda Springs, ID 83276
Phone (208) 547-0700

Organizations & group practices 8

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": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1205339058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 PINE BLUFF LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082523",
            "telephone_number": "208-521-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282",
            "telephone_number": "269-337-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151014599",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101026921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.